Aripiprazole is indicated for:

• Schizophrenia
• Bipolar disorder
• Adjunctive treatment of major depressive disorder
• Irritability associated with autistic disorder
• Agitation related to schizophrenia or bipolar mania

Aripiprazole is an atypical antipsychotic whose therapeutic effects are attributed to its partial agonist activity at dopamine D2 and serotonin 5-HT1A receptors, along with antagonist activity at serotonin 5-HT2A receptors. This unique mechanism helps regulate neurotransmitter activity, resulting in improvement of symptoms associated with schizophrenia, bipolar disorder, depression, autism-related irritability, and agitation.

Schizophrenia: adults

• Initial Dose: 10-15 mg/day
• Recommended Dose: 10-15 mg/day
• Maximum Dose: 30 mg/day

Schizophrenia: adolescents (ages 13-17 years)

• Initial Dose: 2 mg/day
• Recommended Dose: 10 mg/day
• Maximum Dose: 30 mg/day

Bipolar mania: adults: monotherapy

• Initial Dose: 15 mg/day
• Recommended Dose: 15 mg/day
• Maximum Dose: 30 mg/day

Bipolar mania: adults: adjunct to lithium or valproate

• Initial Dose: 10-15 mg/day
• Recommended Dose: 15 mg/day
• Maximum Dose: 30 mg/day

Bipolar mania: pediatric patients (ages 10-17 years): monotherapy or as an adjunct to lithium or valproate

• Initial Dose: 2 mg/day
• Recommended Dose: 10 mg/day
• Maximum Dose: 30 mg/day

As an adjunct to antidepressants for the treatment of major depressive disorder: adults

• Initial Dose: 2-5 mg/day
• Recommended Dose: 5-10 mg/day
• Maximum Dose: 15 mg/day

Irritability associated with autistic disorder: pediatric patients (ages 6-17 years):

• Initial Dose: 2 mg/day
• Recommended Dose: 5-10 mg/day
• Maximum Dose: 15 mg/day

Administration

Oral formulations: Administer once daily without regard to meals.

IM injection: Wait at least 2 hours between doses. Maximum daily dose 30 mg

Aripiprazole should be used cautiously with other centrally acting drugs and alcohol due to potential additive effects. Carbamazepine may increase the clearance of Aripiprazole, leading to reduced plasma levels. In contrast, inhibitors such as ketoconazole, quinidine, fluoxetine, and paroxetine may decrease its metabolism, resulting in increased blood concentrations.

Aripiprazole is contraindicated in patients with known hypersensitivity to the drug.

Common side effects include vomiting, nausea, akathisia, extrapyramidal symptoms, drowsiness, sedation, dizziness, insomnia, tremor, restlessness, fatigue, blurred vision, excessive salivation, constipation, fever, drooling, and decreased appetite.

Pregnancy Category C. Aripiprazole should be avoided during pregnancy unless clearly necessary. Breastfeeding is not recommended while taking this medication.

Elderly with dementia: Increased risk of stroke and cerebrovascular events

Suicidality: Increased risk in children, adolescents, and young adults with depression

Tardive dyskinesia: Discontinue if clinically indicated

Metabolic effects: Risk of hyperglycemia, diabetes, dyslipidemia, and weight gain

Orthostatic hypotension: Use cautiously in cardiovascular or cerebrovascular disease

Seizures: Use with caution in patients with seizure history

Caution is advised when operating machinery

Aripiprazole has been tolerated at doses up to 1080 mg without fatal outcomes. Symptoms of overdose may include nausea, vomiting, weakness, diarrhea, and drowsiness.

Atypical antipsychotic (neuroleptic).

Store below 30°C, protected from light and moisture. Keep out of reach of children.