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aripiprazole
Abilify · Abilify Maintena (LAI) · Aristada (LAI) · Abilify Mycite
Second-generation antipsychotic⚠ Unverified beta content
At a glance
- Class
- Atypical antipsychotic (dopamine D2 partial agonist)
- Black box
- ⚠ Increased mortality in elderly patients with dementia-related psychosis
- ⚠ Suicidal thoughts and behaviors (antidepressant class warning) in patients ≤24 yrs when used for…
- Key monitoring
- Metabolic monitoring (ADA/APA schedule) — Weight/BMI, waist, BP, fasting glucose/A1c, fasting lipids
- Akathisia / EPS / AIMS
- Impulse-control behaviors
- Usual adult dose
- Schizophrenia: 10–15 mg/day start; target 10–30 mg/day
- Call provider / escalate if
- New uncontrollable urges (gambling, shopping, eating, sex) • Severe restlessness / inability to sit still • High fever, stiffness, confusion (NMS)
Built-in explanation — generated offline from this app’s structured data (no AI, no network). Still unverified beta content.
What it is
- aripiprazole (Abilify, Abilify Maintena (LAI), Aristada (LAI)) — atypical antipsychotic (dopamine D2 partial agonist).
- Used for: Schizophrenia; Bipolar I – acute mania/mixed; maintenance; Adjunct for MDD; Irritability associated with autism.
Usual adult dosing
- Schizophrenia: 10–15 mg/day start; target 10–30 mg/day (Max 30 mg/day.)
- Bipolar mania: 15 mg/day start; 15–30 mg/day
- MDD adjunct: 2–5 mg/day start; 2–15 mg/day
- Dose reduction: ≈½ dose with strong CYP2D6 or CYP3A4 inhibitors; ¼ dose with both
Boxed warning
- Increased mortality in elderly patients with dementia-related psychosis: not approved for treatment of dementia-related psychosis.
- Suicidal thoughts and behaviors (antidepressant class warning) in patients ≤24 yrs when used for depression.
Monitor
- Metabolic monitoring (ADA/APA schedule) — Weight/BMI, waist, BP, fasting glucose/A1c, fasting lipids [Baseline; weight at 4, 8, 12 wks then quarterly; BP/glucose/lipids at 12 wks then annually (lipids q5y if normal); more often if abnormal]
- Akathisia / EPS / AIMS [Each visit early; AIMS ≥ every 6–12 months]
- Impulse-control behaviors
Nursing priorities
- Baseline psychiatric symptoms, suicidality, aggression risk.
- Baseline vitals incl. orthostatic BP, weight/BMI, waist circumference.
- Assess for EPS, akathisia, and abnormal movements each shift/visit (AIMS at baseline and periodically per policy).
- Check orthostatic vitals; teach slow position changes; fall precautions.
- Weigh regularly and encourage healthy diet and activity.
Major interactions
- Strong CYP2D6 inhibitors (fluoxetine, paroxetine, quinidine): ↑ aripiprazole – reduce dose by about half.
- Strong CYP3A4 inhibitors (ketoconazole, clarithromycin): ↑ levels – reduce dose by about half.
- CYP3A4 inducers (carbamazepine, rifampin): ↓ levels – may double dose.
Key teaching
- Take it every day even when you feel well. Do not stop suddenly.
- It can make you dizzy when you stand up – rise slowly.
- Regular weight and blood tests check for weight gain and changes in blood sugar and cholesterol.
Optional: AI explanation
Off by default. To enable, add your own API key in Settings (stored only on this device).
Boxed warning
- Increased mortality in elderly patients with dementia-related psychosis: not approved for treatment of dementia-related psychosis.
- Suicidal thoughts and behaviors (antidepressant class warning) in patients ≤24 yrs when used for depression.
Other serious warnings
- Pathological gambling and other impulse-control problems (compulsive gambling, eating, shopping, sex)
- NMS
- Tardive dyskinesia
- Metabolic changes (generally lower weight/lipid effect)
- Orthostatic hypotension
- Leukopenia/neutropenia
- Seizures
- Falls
- Dysphagia
- Body temperature dysregulation
Sources: FDA label (DailyMed): ABILIFY (ARIPIPRAZOLE) TABLET [OTSUKA AMERICA PH
- Metabolic monitoring (ADA/APA schedule)Target: Weight/BMI, waist, BP, fasting glucose/A1c, fasting lipidsWhen: Baseline; weight at 4, 8, 12 wks then quarterly; BP/glucose/lipids at 12 wks then annually (lipids q5y if normal); more often if abnormal
- Akathisia / EPS / AIMSWhen: Each visit early; AIMS ≥ every 6–12 months
- Impulse-control behaviorsGambling, shopping, eating, sexual urges
- Orthostatic BP
- CBCIf history of low WBC or infection signs
Sources: FDA label (DailyMed): ABILIFY (ARIPIPRAZOLE) TABLET [OTSUKA AMERICA PH · ADA/APA Consensus Development Conference on Antipsychotic Drugs and Ob
Assessment
- Baseline psychiatric symptoms, suicidality, aggression risk.
- Baseline vitals incl. orthostatic BP, weight/BMI, waist circumference.
- Baseline AIMS (abnormal movements) and EPS screen.
- History of diabetes, dyslipidemia, cardiac disease, seizures, dementia.
- Substance use and medication/supplement list.
- Ask about gambling, shopping, binge eating, sexual urges.
Interventions
- Assess for EPS, akathisia, and abnormal movements each shift/visit (AIMS at baseline and periodically per policy).
- Check orthostatic vitals; teach slow position changes; fall precautions.
- Weigh regularly and encourage healthy diet and activity.
- Monitor adherence.
- Report fever, rigidity, or altered mental status immediately (NMS).
- Distinguish akathisia (inner restlessness, pacing) from agitation/psychosis – report; do not simply give more antipsychotic.
- Ask directly about new compulsive behaviors.
Sources: General nursing drug reference conventions (e.g., Davis Drug Guide / L
- New uncontrollable urges (gambling, shopping, eating, sex)
- Severe restlessness / inability to sit still
- High fever, stiffness, confusion (NMS)
- Involuntary movements of face/tongue
- Fainting
- Seizure
- Suicidal thoughts
- Trouble swallowing
Sources: FDA label (DailyMed): ABILIFY (ARIPIPRAZOLE) TABLET [OTSUKA AMERICA PH · General nursing drug reference conventions (e.g., Davis Drug Guide / L
- Akathisia (restlessness)
- Nausea, vomiting
- Headache
- Insomnia / somnolence
- Anxiety / agitation
- Constipation
- Lightheadedness
- Tremor
Sources: FDA label (DailyMed): ABILIFY (ARIPIPRAZOLE) TABLET [OTSUKA AMERICA PH
- Strong CYP2D6 inhibitors (fluoxetine, paroxetine, quinidine) Major↑ aripiprazole – reduce dose by about half.
- Strong CYP3A4 inhibitors (ketoconazole, clarithromycin) Major↑ levels – reduce dose by about half.
- CYP3A4 inducers (carbamazepine, rifampin) Major↓ levels – may double dose.
- AntihypertensivesAdditive hypotension.
- Alcohol, CNS depressantsAdditive sedation.
Sources: FDA label (DailyMed): ABILIFY (ARIPIPRAZOLE) TABLET [OTSUKA AMERICA PH
- Take it every day even when you feel well. Do not stop suddenly.
- It can make you dizzy when you stand up – rise slowly.
- Regular weight and blood tests check for weight gain and changes in blood sugar and cholesterol.
- Report muscle stiffness, restlessness (can’t sit still), shaking, or unusual movements of the face or tongue.
- Avoid alcohol and street drugs.
- You may overheat more easily – drink fluids and avoid extreme heat.
- Tell your provider right away if you notice strong urges you can’t control – like gambling, shopping, overeating, or sexual urges.
- Restlessness (feeling you must keep moving) can happen – tell your nurse or provider.
Sources: General nursing drug reference conventions (e.g., Davis Drug Guide / L
Indications
- Schizophrenia
- Bipolar I – acute mania/mixed; maintenance
- Adjunct for MDD
- Irritability associated with autism (pediatric)
- Tourette’s disorder
Dosing
- Schizophrenia: 10–15 mg/day start; target 10–30 mg/dayMax 30 mg/day.
- Bipolar mania: 15 mg/day start; 15–30 mg/day
- MDD adjunct: 2–5 mg/day start; 2–15 mg/day
- Dose reduction: ≈½ dose with strong CYP2D6 or CYP3A4 inhibitors; ¼ dose with both
Sources: FDA label (DailyMed): ABILIFY (ARIPIPRAZOLE) TABLET [OTSUKA AMERICA PH
Prescriber-oriented details; limited in this beta.
cyp Notes
- CYP2D6 & 3A4 substrate; poor metabolizers – half dose.
switching
- Partial agonist; consider cross-titration when switching.
Sources: FDA label (DailyMed): ABILIFY (ARIPIPRAZOLE) TABLET [OTSUKA AMERICA PH
- Verified
- No – unverified beta
- Last reviewed
- 2026-10-29 (drafted; not clinician-reviewed)
- FDA label (DailyMed): ABILIFY (ARIPIPRAZOLE) TABLET [OTSUKA AMERICA PHARMACEUTICAL, INC.]
- ADA/APA Consensus Development Conference on Antipsychotic Drugs and Obesity and Diabetes (Diabetes Care 2004) - metabolic monitoring schedule
- General nursing drug reference conventions (e.g., Davis Drug Guide / Lexicomp nursing) - summarized from standard practice; NOT line-by-line verified