Aripiprazole: Difference between revisions

From SEHK Wiki
Helen (talk | contribs)
No edit summary
Zeki (talk | contribs)
No edit summary
 
(7 intermediate revisions by 2 users not shown)
Line 1: Line 1:
[[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
|-
| rowspan="10" | '''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
|-
|-
|Aripiprazole Tab 5 mg
| Dizziness: Often occurs when standing up quickly; getting up slowly can help
|ARIP03
|P1S1S3
|-
|-
|Aripiprazole Tab 10 mg
| Weight Changes: Can cause weight gain or loss; maintaining a balanced diet is recommended
|ARIP01
|P1S1S3
|-
|-
|Aripiprazole Tab 15 mg
| Increased Salivation: More common in children
|ARIP02
|-
|P1S1S3
| Fatigue: Feeling tired or low in energy
|}
 
==Mechanism of Action==
Aripiprazole is a dopamine D2 partial agonist. It is also a partial activator of serotonin 5-HT1A receptors.
Aripiprazole acts by modulating neurotransmission overactivity of dopamine, which is thought to mitigate schizophrenia symptoms.
 
==Dosage==
{| class="wikitable"
!style="text-align: left"| Indication
!style="text-align: left"| Dose
|-
|-
!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


It is not recommended for older people with dementia-related psychosis due to an increased risk of death.
* Monitor for suicidal thoughts and behaviors, especially in younger patients
Discontinuation
* May cause increased blood sugar, elevated cholesterol, and weight gain
* Regular monitoring of metabolic parameters are recommended


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.
'''Drug Interactions


==Pharmacokinetics==
* Strong CYP3A4 inhibitors and CYP2D6 inhibitors may increase aripiprazole levels
{|class="wikitable"
* Strong CYP3A4 inducers may decrease aripiprazole levels
!style="text-align: left"| Oral bioavailability
|It is readily absorbed after oral doses.
|-
!style="text-align: left"| Onset of action
|Peak plasma concentrations are achieved 3 – 5 hours after an oral dose.
|-
!style="text-align: left"| Metabolism
|It is metabolized in the liver, principally by the enzymes CYP2D6 and CYP3A4
|-
!style="text-align: left"| Elimination half-life
|
It is eliminated via urine and faeces.


The elimination half-life is approximately 75 hours.
==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.


Steady-state plasma concentrations are achieved in about 14 days.  
'''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.

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.