ADD Medication and Treatment Reviews

Abilify

Generic name: aripiprazole

What is Abilify?

Abilify is an anti-psychotic medication primarily used to treat symptoms of schizophrenia in patients over age 13, bipolar disorder in patients over age 10, depression in adults, irritability associated with autism in children over age six, and Tourette’s Syndrome in children over age six. Studies suggest that aripiprazole may have a dopamine-stabilizing effect on patients with ADHD1; some clinicians include it in ADHD treatment plans for both adults and children, particularly those who do not respond to stimulants2.

The safety and effectiveness of taking Abilify to treat depression or the agitation associated with schizophrenia or bipolar mania in children has not been established. Abilify can be dangerous for elderly people with dementia.

How to Use Abilify

Before starting or refilling an Abilify prescription, read the medication guide included with your pills, as it may be updated with new information.

This guide should not replace a conversation with your doctor, who has a holistic view of your medical history, other diagnoses, and other prescriptions. If you have questions, ask your doctor or pharmacist before you begin taking the medication.

Dosage for Abilify

As with all medications, follow your Abilify prescription instructions exactly. The optimal dosage varies by age and condition treated. Abilify is available in several formulations:

  • Abilify Tablets are available in 2mg, 5mg, 10mg, 15mg, 20mg, and 30mg dosages. Tablets should be swallowed whole with water or another liquid.
  • Abilify DISCMELT (Orally Disintegrating Tablets): To keep it from dissolving before you place the tablet in your mouth, leave it contained in its blister package until you are ready to take it. When opening the medication, make sure your hands are clean and dry so as not to accidentally trigger dissolution. Peel back the blister package backing to take out the tablet, instead of pushing it through the foil. Place the tablet on your tongue to dissolve. Do not crush or chew the tablet. Orally disintegrating tablets are available in 10mg and 15 mg dosages. It is recommended they are taken without liquid.
  • Abilify Oral Solution: Colorless, orange-flavored liquid. The liquid should be measured with the included device and swallowed entirely with water or another liquid. The oral solution is available in a concentration of 1mg/mL.
  • Abilify Injection: The intramuscular injection is available in 9.75mg/1.3mL single dose vials.

The oral formulations are taken once daily, with our without food. Oral formulations are indicated for every condition except the agitation associated with schizophrenia or bipolar mania.

The injection should be taken no more than once every two hours, with a maximum daily dosage of 30mg. The injection is only indicated to treat the agitation associated with schizophrenia or bipolar mania.

If you miss a dose, you should take it as soon as possible, unless it is already time for your next dose. You should not take two doses of Abilify at the same time. Contact your doctor if you have questions about skipped pills.

When discontinuing treatment, or decreasing dosage, patients should work with a doctor to gradually taper the level of medication. Stopping Abilify suddenly can create new, serious symptoms.

Side Effects Associated with Abilify

The most common side effects of Abilify are as follows:

Children and Adolescents (ages 10 to 17): sleepiness, headache, vomiting, fatigue, changes in appetite, increased saliva, insomnia, nausea, stuffy nose, weight gain, uncontrolled movement, and muscle stiffness.

Adults: nausea, vomiting, constipation, headache, blurred vision, upper respiratory illness, dizziness, anxiety, insomnia, and restlessness.

Elderly people with dementia-related psychosis are at increased risk of death from stroke when treated with Abilify.

Medications like Abilify can increase risk of suicide and suicidal thoughts, especially at the start of treatment. Report to your healthcare provider any sudden changes in mood, including depression, anxiety, restlessness, panic, irritability, impulsivity, or aggression.

Other serious side effects include low white blood cell count, seizures, dyslipidemia, problems regulating body temperature, and pathological gambling or other compulsive behaviors.

Taking Abilify may impair your ability to drive, operate machinery, or perform other potentially dangerous tasks. This side effect usually wears off with time. If side effects are bothersome, or do not go away, talk to your doctor.

Most people taking this medication do not experience any of these side effects.

Abilify can increase a patient’s risk of neuroleptic malignant syndrome (NMS). This is a rare, but serious condition that can cause a stroke resulting in death. If you experience high fever, sweating, rigid muscles, confusion, or changes in breathing or heartbeat, these could be warning signs of NMS and you should seek medical help at a hospital immediately.

Tell your doctor if you have diabetes or difficulty managing your blood sugar. Taking Abilify can increase blood sugar which, when untreated, can cause ketoacidosis, coma, or death. Warning signs of hyperglycemia include: excessive thirst, frequent urination, feeling very hungry, weak, tired or nauseous, fruit-scented breath, and nausea. If you experience these, contact your healthcare provider.

Some people experience tardive dyskinesia, a condition which causes uncontrollable movements in the face, tongue, or other body parts. This may not go away, even if you stop taking Abilify.

While taking Abilify, your doctor should regularly monitor the fat levels in your blood (cholesterol and triglycerides), weight, and blood pressure. Abilify can increase blood fat levels, cause weight gain, and create sudden changes in blood pressure, especially in children and teenagers.

The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

Precautions Associated with Abilify

Store Abilify in a secure place out of the reach of children, and at room temperature. Do not share your Abilify prescription with anyone, even another person with schizophrenia or bipolar disorder. Sharing prescription medication is illegal, and can cause harm.

You should not take Abilify if you have an allergy to aripiprazole or any of the ingredients in Abilify. Before taking Abilify, tell your doctor if you have a personal or family history of diabetes, abnormal blood pressure, low white blood cell count, or heart problems.

Do not become overheated or dehydrated while taking Abilify. This includes avoiding extremely strenuous exercise, spending time in the sun, or wearing too-heavy clothing.

If you’re thinking of becoming pregnant, discuss the use of Abilify with your doctor. Especially when taken in the last three months of pregnancy, it is suspected to cause fetal harm. It is recommended that mothers do not nurse while taking Abilify, as it is unsafe for infants, and Abilify passes into breastmilk.

Interactions Associated with Abilify

Before taking Abilify, discuss all other active prescription medications with your doctor.

Medications that inhibit or induce CYP2D6 or CYP3A4, enzymes that metabolize certain drugs, can increase or decrease how the body absorbs Abilify. Physicians may need to increase or decrease Abilify dosage when taken with prescriptions like itraconazole, fluoxetine, carbamazepine, rifampin, and lorazepam.

Share a list of all vitamin or herbal supplements, prescription, and non-prescription medications you take with the pharmacist when you fill your prescription, especially any drugs that cause drowsiness. Let all doctors and physicians know you are taking Abilify before having any surgery or laboratory tests.

The above is not a complete list of all possible drug interactions.

1Robert L Findling, MD. “The Cognitive Effects of Aripiprazole in Children.” University Hospital Case Medical Center. 2005-2014
2Dr.Yannick Pauli. “Abilify for ADHD: An Antipsychotic with Worrisome Side Effects” Dr. Yannick Pauli’s UnRitalin Solution. (2010). Web. (http://www.unritalinsolution.com/adhdblog/2010/06/28/abilify-for-adhd/)

Sources:

https://www.abilify.com/

2 Abilify Related Links

  1. My 5 yr old son is taking Abilify and Intuniv for ADHD and ODD. I want to know if any parents have success stories about this combo. His behavior has definitely improved, but it seems like this combo is not helping him with the attention/focusing issues. Before this, he was on Vyvanse, Strattera, Focalin, and all those made him lose too much weight and become aggressive.
    Any advise?

  2. Some thoughts to irlawrence re her/his concerns about the ineffectiveness of the Abilify and Intuniv cocktail on the child’s focus and attentiveness.
    Abilify is usually used to address the behavioral aspects of ADHD more so than the inattentive, distractability, problems with ADD/HD. Similar emphasis for Intuniv.
    You didn’t mention whether the other meds that had been tried before did help those areas of dysfunction, but only that the side effect of decreased appetite was a problem, and whether or not the current medicines were started after those had been stopped, or were taken together. One of the known side effects of Ability is weight gain. If it has not been used together with a (starting) low dose of Vyvanse (easy to titrate because the powder can be put in a measured amount of water and take only a measured amount of that, so dose changes can be in very small steps, like 5 or 10 mg increases (or decreases), or can try the liquid forms of either immediate or extended release methylphenidate or dextroamphetamine, or Adderall tablets….
    Starting low you can monitor the appetite changes, if any, and possibly the weight gaining side effect of the Abilify might help ‘balance’ each other out, so you can get the benefit of the gold standard central nervous system medicines for the attention, focus, group of symptoms……
    Also, make sure your son eats a big breakfast (before the medicine kicks in) and dinner — even if it’s a little later than you might prefer, and also don’t get hung up on how nutritious everything going into his mouth has to be, as long as it’s calories — ice cream, french fries, etc., and accept that he might eat light at school lunch time, but be sure he drinks fluids to stay hydrated.
    It’s worth talking to your pediatrician or child psychiatrist about…..

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