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[[Category: Drugs]][[Category: Antipsychotics, typical; Antipsychotic 2nd Generation]]
[[Category: Drugs]][[Category: Atypical antipsychotic ]]
'''Aripiprazole''' (中文:[[      ]]) is an atypical antipsychotic or 2nd Generation antipsychotic medication. It is mainly used in the treatment of
*Schizophrenia: there is little difference in effectiveness between antipsychotics in prevention of relapse, the specific choice of antipsychotic be chosen based on person’s preference and side-effect profile.
*bipolar disorder: aripiprazole is effective for the treatment of acute manic episodes of bipolar disorder.It is useful for the prevention of manic episodes, but is not useful for bipolar depression.
*adjuinct treatment of major depressive disoreder


Aripiprazole rebalances dopamine and serotonin to improve thinking, mood and behaviour.
[[:Category: Antipsychotic Drug | '''Antipsychotic Drug''']]


==Pronunciation==
'''Drug class: [[:Category: Atypical antipsychotic  | Atypical Antipsychotic ]]


==Drug Names==
'''Aripiprazole (ABILIFY)'''(中文:[[阿立哌唑]])
==Common Strengths of Aripiprazole Tablet==
Aripiprazole tablets are available in the following strengths:
*2 mg, 5 mg, 10 mg, 15 mg, 30 mg tablets
 
==Drug Trade Names of Aripiprazole Tablet==
Abilify
 
==Drug Usage==
Aripiprazole is used for:
* Schizophrenia
* Bipolar disorder
* Major depressive disorder (as an adjunct)
* Tourette syndrome
* Autism-related irritability
 
==Mechanism of Action==
Aripiprazole is a partial agonist at dopamine D2 and serotonin 5-HT1A receptors, and an antagonist at serotonin 5-HT2A receptors.
 
==Route of Administration==
* Oral (tablets and oral solution)
 
==Dosages==
* Schizophrenia (adults): Initial dose 10 - 15 mg/day, target dose 10 - 15 mg/day, maximum 30 mg/day
* Bipolar disorder (adults): Initial dose 15 mg/day, maximum 30 mg/day
 
Aripiprazole does not require dosage adjustment based on renal function, including in patients with severe renal impairment or end-stage renal disease (ESRD). This is
 
because aripiprazole is primarily metabolized in the liver and only a small fraction is excreted unchanged in the urine.
 
==Side Effects==
*Detailed percentage-based side effect information not provided in the search results.
{| class="wikitable"
{| class="wikitable"
!Generic Name 藥名
!style="text-align: left"| Frequency
!HA Code 藥物代碼
!Adverse reactions
!Classification藥物分類
|-
|-
|Aripiprazole Tab 5 mg
| rowspan="10" | '''Common
|ARIP03
| Insomnia: Difficulty sleeping, which often improves over time.
|P1S1S3
|-
|-
|Aripiprazole Tab 10 mg
| Anxiety and Restlessness: Feelings of anxiety and restlessness that usually subside with continued use
|ARIP01
|P1S1S3
|-
|-
|Aripiprazole Tab 15 mg
| Dizziness
|ARIP02
|-
|P1S1S3
| Headache: Common and can be managed with rest and hydration
|}
|-
 
| Nausea and Vomiting: Can be mitigated by taking the medication with food
==Mechanism of Action==
|-
Aripiprazole is a dopamine D2 partial agonist. It is also a partial activator of serotonin 5-HT1A receptors.
| Constipation: Increasing dietary fiber and water intake can help
Aripiprazole acts by modulating neurotransmission overactivity of dopamine, which is thought to mitigate schizophrenia symptoms.
|-
 
| Dizziness: Often occurs when standing up quickly; getting up slowly can help
==Dosage==
|-
{| class="wikitable"
| Weight Changes: Can cause weight gain or loss; maintaining a balanced diet is recommended
!style="text-align: left"| Indication
|-
!style="text-align: left"| Dose
| Increased Salivation: More common in children
|-
| Fatigue: Feeling tired or low in energy
|-
|-
!style="text-align: left"| Schizophrenia 
| rowspan="7" | '''Uncommon
|By ''mouth
| Neuroleptic Malignant Syndrome (NMS): Symptoms include high fever, muscle stiffness, and altered mental status
ADULT:
*10 – 15 mg once daily,  
*Maximum 30 mg once daily
|-
|-
!style="text-align: left"| Treatment and recurrence prevention of mania
| Metabolic Changes: Increased blood sugar, cholesterol, and weight gain, which can lead to diabetes
|By ''mouth
ADULT:
*15 mg once daily
*Maximum 30 mg once daily
|-
|-
!style="text-align: left"| Adjunct treatment of major depressive disorder
| Compulsive Behaviors: Uncontrollable urges to gamble, eat, shop, or engage in sexual activities
|By ''mouth
ADULT:
*Initially 2- 5 mg once daily,  
*Increased to 5 – 10 mg once daily
*Maximum 15 mg once daily
|}
 
How long does it take for Amisulpride to work?
The patient may start to feel better in a few days but it can take as long as 4 to 6 weeks before the full effects of this medication is noticed.
 
==Side Effects==
All side-effects are listed by system organ and frequency.
*Common ( ≥ 1/100 to < 1/10)
*Uncommon (≥ 1/1000 to < 1/100)
 
{| class = "wikitable"
!style="text-align: left"| Endocrine disorders
|
Uncommon: hyperprolactinaemia (elevated levels of the hormone prolactin, which for females may result in
*Galactorrhea (unwanted breast milk)
*amornorrhea (missed/stopped periods),  
For males it may result in
*decreased sexual ability, or
*gynecomastia (enlarged breast)
|-
|-
!style="text-align: left"| Muscle/Nervous system disorders:
| Orthostatic Hypotension: Sudden drop in blood pressure upon standing, leading to dizziness or fainting
|
Common:
*Extrapyramidal symptoms (EPS)
-Tremor
-Akathisia
-Parkinsonism
*Anticholinergic side-effects such as:
-Dry mouth
-Constipation
-Blurred vision
*headache
*sedation
*somnolence
*dizziness
*salivary hypersecretion
Uncommon: tardive dyskinesia and seizures
Not known: Neuroleptic malignant syndrome
|-
|-
!style="text-align: left"| Psychiatric disorders
| Seizures: Convulsions that require immediate medical attention
|
Common:
*Insomnia
*Anxiety
*Restlessness
Uncommon:
*Depression
*hypersexuality
|-
|-
!style="text-align: left"| Metabolism disorders
| Severe Allergic Reactions: Symptoms include swelling of the face, lips, tongue, or throat, and difficulty breathing
|
Common:
*diabetes mellitus
*weight gain
Uncommon:
*Hyponatraemia
*Anorexia
|-
|-
!style="text-align: left"| Cardiac disorders
| Suicidal Thoughts: Increased risk in young people, particularly those under 24
|
Uncommon:  
*tachycardia
*orthostatic hypotension
|}
|}


Pathological gambling, compulsive shopping and binge eating can occur in patients treated with aripiprazole.  
==Pharmacokinetics==
*Absorption
**Aripiprazole is well absorbed after oral administration, with peak plasma concentrations occurring within 3 to 5 hours
*Metabolism
**Extensively metabolized in the liver, primarily by CYP3A4 and CYP2D6 enzymes
*Elimination
** The mean elimination half-life is about 75 hours for aripiprazole
 
Aripiprazole has a relatively rapid initial onset of action within 1 to 2 weeks for most patients, but full therapeutic effects may take several weeks to months to develop.
 
Its long half-life results in a prolonged duration of action, allowing for once-daily dosing and steady-state levels after about 2 weeks of treatment.
 
==Drug Precautions==
'''Increased risk in elderly patients
 
* Should not be used to treat dementia-related psychosis in older adults due to increased risk of stroke and death
* May cause drowsiness, dizziness, and difficulty swallowing in elderly patients, increasing the risk of falls and choking
 
'''Suicidal thoughts in young people
 
* May increase the risk of suicidal thoughts in people under 24 years old, especially in the first few months of treatment or with dose changes
* Close monitoring is required for children/teens taking aripiprazole
 
''' Monitoring Requirements
 
* Monitor for suicidal thoughts and behaviors, especially in younger patients
* May cause increased blood sugar, elevated cholesterol, and weight gain
* Regular monitoring of metabolic parameters are recommended
 
'''Drug Interactions
 
* Strong CYP3A4 inhibitors and CYP2D6 inhibitors may increase aripiprazole levels
* Strong CYP3A4 inducers may decrease aripiprazole levels
 
==FAQ==
'''How Should I Take the Tablet?
* Standard tablets: Swallow with water
* Orodispersible tablets: Place on tongue to dissolve or dissolve in water and drink immediately
* Take at around the same time each day, with or without food.


It is not recommended for older people with dementia-related psychosis due to an increased risk of death.  
'''What should I avoid while taking?
Discontinuation
*Avoid driving, operating machinery or doing activities that require alertness until you know how the medication affects you.
*Do not stop taking amisulpride suddenly without consulting your doctor. Abrupt withdrawal can cause unpleasant side effects or a return of symptoms.


It is recommended that gradual withdrawal when discontinuing antipsychotics. Symptoms of withdrawal commonly include nausea, vomiting and loss of appetite. Symptoms generally resolve after a short period of time.
'''What Happens if I Miss a Dose?
*Take the missed dose as soon as you remember if it is within a few hours. If it is close to the next scheduled dose, skip the missed dose and continue with the regular schedule.

Latest revision as of 01:17, 19 July 2024


Antipsychotic Drug

Drug class: Atypical Antipsychotic

Aripiprazole (ABILIFY)(中文:阿立哌唑

Common Strengths of Aripiprazole Tablet[edit]

Aripiprazole tablets are available in the following strengths:

  • 2 mg, 5 mg, 10 mg, 15 mg, 30 mg tablets

Drug Trade Names of Aripiprazole Tablet[edit]

Abilify

Drug Usage[edit]

Aripiprazole is used for:

  • Schizophrenia
  • Bipolar disorder
  • Major depressive disorder (as an adjunct)
  • Tourette syndrome
  • Autism-related irritability

Mechanism of Action[edit]

Aripiprazole is a partial agonist at dopamine D2 and serotonin 5-HT1A receptors, and an antagonist at serotonin 5-HT2A receptors.

Route of Administration[edit]

  • Oral (tablets and oral solution)

Dosages[edit]

  • Schizophrenia (adults): Initial dose 10 - 15 mg/day, target dose 10 - 15 mg/day, maximum 30 mg/day
  • Bipolar disorder (adults): Initial dose 15 mg/day, maximum 30 mg/day

Aripiprazole does not require dosage adjustment based on renal function, including in patients with severe renal impairment or end-stage renal disease (ESRD). This is

because aripiprazole is primarily metabolized in the liver and only a small fraction is excreted unchanged in the urine.

Side Effects[edit]

  • Detailed percentage-based side effect information not provided in the search results.
Frequency Adverse reactions
Common Insomnia: Difficulty sleeping, which often improves over time.
Anxiety and Restlessness: Feelings of anxiety and restlessness that usually subside with continued use
Dizziness
Headache: Common and can be managed with rest and hydration
Nausea and Vomiting: Can be mitigated by taking the medication with food
Constipation: Increasing dietary fiber and water intake can help
Dizziness: Often occurs when standing up quickly; getting up slowly can help
Weight Changes: Can cause weight gain or loss; maintaining a balanced diet is recommended
Increased Salivation: More common in children
Fatigue: Feeling tired or low in energy
Uncommon Neuroleptic Malignant Syndrome (NMS): Symptoms include high fever, muscle stiffness, and altered mental status
Metabolic Changes: Increased blood sugar, cholesterol, and weight gain, which can lead to diabetes
Compulsive Behaviors: Uncontrollable urges to gamble, eat, shop, or engage in sexual activities
Orthostatic Hypotension: Sudden drop in blood pressure upon standing, leading to dizziness or fainting
Seizures: Convulsions that require immediate medical attention
Severe Allergic Reactions: Symptoms include swelling of the face, lips, tongue, or throat, and difficulty breathing
Suicidal Thoughts: Increased risk in young people, particularly those under 24

Pharmacokinetics[edit]

  • Absorption
    • Aripiprazole is well absorbed after oral administration, with peak plasma concentrations occurring within 3 to 5 hours
  • Metabolism
    • Extensively metabolized in the liver, primarily by CYP3A4 and CYP2D6 enzymes
  • Elimination
    • The mean elimination half-life is about 75 hours for aripiprazole

Aripiprazole has a relatively rapid initial onset of action within 1 to 2 weeks for most patients, but full therapeutic effects may take several weeks to months to develop.

Its long half-life results in a prolonged duration of action, allowing for once-daily dosing and steady-state levels after about 2 weeks of treatment.

Drug Precautions[edit]

Increased risk in elderly patients

  • Should not be used to treat dementia-related psychosis in older adults due to increased risk of stroke and death
  • May cause drowsiness, dizziness, and difficulty swallowing in elderly patients, increasing the risk of falls and choking

Suicidal thoughts in young people

  • May increase the risk of suicidal thoughts in people under 24 years old, especially in the first few months of treatment or with dose changes
  • Close monitoring is required for children/teens taking aripiprazole

Monitoring Requirements

  • Monitor for suicidal thoughts and behaviors, especially in younger patients
  • May cause increased blood sugar, elevated cholesterol, and weight gain
  • Regular monitoring of metabolic parameters are recommended

Drug Interactions

  • Strong CYP3A4 inhibitors and CYP2D6 inhibitors may increase aripiprazole levels
  • Strong CYP3A4 inducers may decrease aripiprazole levels

FAQ[edit]

How Should I Take the Tablet?

  • Standard tablets: Swallow with water
  • Orodispersible tablets: Place on tongue to dissolve or dissolve in water and drink immediately
  • Take at around the same time each day, with or without food.

What should I avoid while taking?

  • Avoid driving, operating machinery or doing activities that require alertness until you know how the medication affects you.
  • Do not stop taking amisulpride suddenly without consulting your doctor. Abrupt withdrawal can cause unpleasant side effects or a return of symptoms.

What Happens if I Miss a Dose?

  • Take the missed dose as soon as you remember if it is within a few hours. If it is close to the next scheduled dose, skip the missed dose and continue with the regular schedule.