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
- Initial Dose: 2 mg/day
- Recommended Dose: 10 mg/day
- Maximum Dose: 30 mg/day
- Initial Dose: 15 mg/day
- Recommended Dose: 15 mg/day
- Maximum Dose: 30 mg/day
- Initial Dose: 10-15 mg/day
- Recommended Dose: 15 mg/day
- Maximum Dose: 30 mg/day
- Initial Dose: 2 mg/day
- Recommended Dose: 10 mg/day
- Maximum Dose: 30 mg/day
- Initial Dose: 2-5 mg/day
- Recommended Dose: 5-10 mg/day
- Maximum Dose: 15 mg/day
- 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.
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.
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.
