Aripiprazole

Indications

Aripiprazole is indicated for-
  • Schizophrenia
  • Bipolar disorder
  • Adjunctive treatment of major depressive disorder
  • Irritability associated with autistic disorder
  • Agitation associated with schizophrenia or bipolar mania

Pharmacology

Aripiprazole is an atypical antipsychotic and it has been proposed that the efficacy of Aripiprazole is mediated through a combination of partial agonist activity at Dopamine D2 and Serotonin 5-HT 1A receptors and antagonist activity at Serotonin 5-HT 2A receptors. This is associated with improvement of schizophrenia, bipolar disorder, major depressive disorder, irritability associated with autistic disorder, and agitation associated with schizophrenia or bipolar disorder.

Dosage

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.

Interaction

Caution should be exercised when Aripiprazole is taken in combination with other centrally acting drugs and alcohol. Carbamazepine could cause an increase in Aripiprazole clearance and lower blood levels. Ketoconazole, quinidine, fluoxetine or paroxetine can inhibit Aripiprazole elimination and cause increased blood levels.

Contraindications

Known hypersensitivity to Aripiprazole.

Side Effects

Vomiting, nausea, akathisia, extrapyramidal disorder, somnolence, sedation, dizziness, insomnia, tremor, restlessness, fatigue, blurred vision, salivary hypersecretion, constipation, pyrexia, drooling, decreased appetite.

Pregnancy & Lactation

Pregnancy category C. It should be avoided during pregnancy. It is recommended that women receiving Aripiprazole should not breast-feed.

Precautions & Warnings

Elderly Patients with Dementia-Related Psychosis: Increased incidence of cerebrovascular adverse events (eg, stroke, transient ischemic attack, including fatalities).

Suicidality & antidepressants: Increased risk of suicidality in children, adolescents, young and adults with major depressive disorder.

Tardive dyskinesia: Discontinue if clinically appropriate.

Metabolic changes: Atypical antipsychotic drugs have been associated with metabolic changes that include hyperglycemia/diabetes mellitus, dyslipidemia, and body weight gain.

Orthostatic hypotension: Use with caution in patients with known cardiovascular or cerebrovascular disease.

Seizures/Convulsions
: Use cautiously in patients with a history of seizures.

Use caution when operating machinery.

Overdose Effects

Aripiprazole at doses up to 1080 mg causes no fatalities. The signs and symptoms observed with aripiprazole overdose included nausea, vomiting, asthenia, diarrhea, and somnolence.

Therapeutic Class

Atypical neuroleptic drugs

Storage Conditions

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.