Aripiprazole is an atypical antipsychotic drug, commonly sold under the trade names Abilify, Bosqin and ARISTADA®.
Aripiprazole was approved for medical use in the United States in 2002. It is available as a generic drug. In 2020, it was the 89th most commonly prescribed drug in the United States, with more than 8 million prescriptions filled. Included in the World Health Organization's list of essential medicines.
medical use
Aripiprazole is primarily used to treat schizophrenia or bipolar disorder.
Schizophrenia
The 2016 (National Institute for Health and Care Excellence) NICE guidance on the treatment of psychosis and schizophrenia in children and young people recommends aripiprazole as a preservative for patients aged 15 to 17 years with an acute episode or relapse of psychosis or schizophrenia. Second-line therapy after ketosis. A 2014 NICE review of long-acting formulations of this drug found that it may be an alternative to other long-acting formulations of second-generation antipsychotics for people who have difficulty taking their medication as directed or who prefer to take it.
A 2014 Cochrane review compared aripiprazole with other atypical antipsychotics and found that it was difficult to determine differences due to poor data quality. A 2011 Cochrane review comparing aripiprazole with placebo concluded that high dropout rates from clinical trials and a lack of outcome data on general functioning, behaviour, mortality, economic outcomes or cognitive function, making it difficult to definitively conclude that aripiprazole is useful in preventing relapse. A Cochrane review found only low-quality evidence of effectiveness in treating schizophrenia. Therefore, part of its approach to the quality of evidence is based on the number of eligible studies.
A 2013 review ranked aripiprazole's effectiveness in the middle range of 15 antipsychotics, about as effective as haloperidol and quetiapine and less effective than ziprasidone, chlorpromazine and asena Moderately effective, better tolerated than other antipsychotics (ranked 4th for reducing weight gain), 2nd best for reducing extrapyramidal symptoms, best for prolonging the QTc interval 2nd best way to calm symptoms, 5th best way to calm symptoms). The authors concluded that aripiprazole provides some benefit in acute psychotic episodes.
In 2013, the World Federation of Biopsychiatric Societies recommended aripiprazole as a Class 1 recommendation and Level A evidence for the treatment of acute exacerbations of schizophrenia.
The British Society of Psychopharmacology similarly recommends that all people with psychosis be treated with antipsychotics and that this treatment should be continued for at least 1-2 years because "there is no doubt that discontinuation of antipsychotics during this period is strongly associated with relapse" ”. The guidelines further state that “diagnosed schizophrenia requires ongoing maintenance treatment with antipsychotic doses within the recommended range (level A evidence).”
The British Association of Psychopharmacology and the World Federation of Biopsychiatric Societies agree that there is little variation in the effectiveness of antipsychotics in preventing relapse and recommend a personal selection of antipsychotic profiles based on each person's preferences and side effects. The latter recommends switching to aripiprazole when excessive weight gain occurs during treatment with other antipsychotics.
bipolar disorder
Aripiprazole is effective in treating acute manic episodes of bipolar disorder in adults, children, and adolescents. It is used as maintenance treatment to prevent episodes of mania, but is not effective in bipolar depression. Therefore, it is often used in combination with additional mood stabilizers; however, coadministration with mood stabilizers increases the risk of extrapyramidal side effects. In September 2014, aripiprazole obtained marketing authorization in the UK for the treatment of moderate to severe manic episodes in young people over the age of 13 with moderate to severe bipolar disorder, for up to 12 weeks.
major depression
Aripiprazole is an effective complementary therapy for the treatment of major depression; however, there is a high incidence of side effects, such as weight gain and movement disorders. Overall benefit is small to moderate, and its use does not appear to improve either quality of life or function. Aripiprazole may interact with some antidepressant medications, especially selective serotonin reuptake inhibitors (SSRIs) metabolized by CYP2D6. There are known interactions with fluoxetine and paroxetine, and appear to be less likely to interact with sertraline, escitalopram, citalopram, and fluvoxamine. CYP2D6 inhibitors may increase aripiprazole concentrations to 2-3 times normal values. The FDA recommends dose monitoring when strong CYP2D6 SSRI inhibitors (e.g., fluoxetine, paroxetine) are coadministered, but it is unclear whether the SSRI dose should be reduced if paroxetine or fluoxetine and aripiprazole are coadministered.
autism
Short-term data (8 weeks) showed reductions in irritability, hyperactivity, inappropriate speech, and stereotypy, but no change in sleepiness behaviors. Adverse effects include weight gain, drowsiness, drooling, and tremors. It is recommended that children and adolescents need regular monitoring while taking this medication to evaluate whether the treatment regimen is still effective after long-term use and to watch for worsening of side effects. Further research is needed to understand whether this drug helps children after long-term use.
tics
Aripiprazole is approved for the treatment of Tourette syndrome and tics. Based on a systematic review and meta-analysis, this use is effective, safe, and well tolerated.
obsessive-compulsive disorder
A 2014 systematic review and meta-analysis concluded that add-on therapy with low-dose aripiprazole is an effective treatment for obsessive-compulsive disorder (OCD), but selective serotonin reuptake inhibitors (SSRIs) alone ) does not improve obsessive-compulsive disorder. This conclusion is based on the results of two relatively small short-term trials, each of which demonstrated improvements in symptoms. However, a 2017 review of antipsychotic treatments for obsessive-compulsive disorder cautiously recommended aripiprazole. Aripiprazole is not currently approved for the treatment of obsessive-compulsive disorder and is used off-label for this indication. Depending on the dose, aripiprazole may increase impulse control problems in a small number of people. FDA Drug Safety Communications warn about this side effect. Alternatively, risperidone, at a dose of approximately 2 to 3 mg per day, is a more typical reinforcing drug used in cases of OCD that do not respond adequately to selective serotonin reuptake inhibitors or clomipramine alone. Haloperidol (at a dose of approximately 5 mg per day) may have a similar effect, but only in cases with a history of tics.
It can also be used in combination with other medications to treat depression. Aripiprazole is known as an antipsychotic (atypical). It works by helping to restore the balance of certain natural chemicals (neurotransmitters) in the brain.How to use Alibif
Take this medication by mouth with or without food as directed by your doctor, usually once daily. The dosage is based on your medical condition, response to treatment, age, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all prescription, nonprescription, and herbal products you use. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and then gradually increase your dose. Follow your doctor's instructions carefully.
The manufacturer directs that this medication be swallowed whole. However, many similar medications can be divided/crushed. Follow your doctor's instructions on how to take this medication.
If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/cup. Do not use a household spoon as you may not get the correct dose.
Do not increase your dose or use this medication more often or for longer than prescribed. Your condition will not improve faster, and your risk of side effects will increase.
It may take several weeks for you to get the full effects of this medication. Use this medication regularly to get the most benefit. To help you remember, take it at the same time every day.
Continue taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when the drug is stopped suddenly. Your dose may need to be reduced gradually.
Tell your doctor if your condition does not improve or worsens.
side effect
Dizziness, lightheadedness, drowsiness, nausea, vomiting, tiredness, excessive salivation/drooling, blurred vision, weight gain, constipation, headache, and trouble sleeping may occur. If these effects persist or get worse, tell your doctor or pharmacist promptly.
Dizziness and lightheadedness can increase your risk of falling. When rising from a sitting or lying position, rise slowly.
This medication is prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people who use this drug do not experience serious side effects.
Tell your doctor right away if you have any serious side effects, including: fainting, mental/mood changes (such as anxiety, depression, increased suicidal thoughts), difficulty swallowing, restlessness (especially in the legs), shaking (tremors), Muscle spasms, facial expressions like a mask, seizures, difficulty controlling certain impulses (such as gambling, sex, eating, or shopping), interruptions in breathing during sleep.
This medication may rarely increase your blood sugar, which may cause or worsen diabetes. Tell your doctor right away if you have symptoms of high blood sugar, such as increased thirst/urination. If you already have diabetes, follow instructions to check your blood sugar regularly and share the results with your doctor. Your doctor may need to adjust your diabetes medications, exercise program, or diet.
This drug may rarely cause tardive dyskinesia. In some cases, the condition may be permanent. Tell your doctor right away if you have any unusual, uncontrolled movements (especially of your face, mouth, tongue, arms, or legs).
This drug can rarely cause a very serious condition called neuroleptic malignant syndrome (NMS). Get medical help right away if you have any of the following symptoms: fever, muscle stiffness/pain/tenderness/weakness, severe tiredness, severe confusion, sweating, fast/irregular heartbeat, dark urine, signs of kidney problems ( For example, changes in kidney function) urine output).
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever, swollen lymph nodes, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
Precaution
Before taking aripiprazole, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as propylene glycol), which may cause allergic reactions or other problems. Ask your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood flow problems to the brain (such as cerebrovascular disease, stroke), diabetes (including family history), heart problems (such as low blood pressure, coronary heart disease) heart disease) arterial disease, heart failure, irregular heartbeat), neurological problems (such as dementia, NMS, epilepsy), obesity, low white blood cell count (including a history of low white blood cell count caused by medications), swallowing problems, difficulty breathing or sleeping (sleep apnea).
This drug may make you dizzy, drowsy, or have blurred vision. Alcohol or marijuana can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that requires alertness or clear vision until you can do it safely. Avoid alcohol.
This medication may make you sweat less, making you more likely to have heat stroke. Avoid doing things that may cause overheating, such as working or exercising hard in hot weather, or using a hot tub. When the weather is hot, drink plenty of fluids and wear light clothing. If you become overheated, quickly find a cooler place and rest. If you have a persistent fever, mental/mood changes, headache, or dizziness, seek medical attention immediately.
Liquid formulations of this product may contain sugar. Caution is advised if you have diabetes. Ask your doctor or pharmacist about using this product safely.
Older adults may be more sensitive to the side effects of this drug, especially seizures, drowsiness, dizziness, confusion, tardive dyskinesia, swallowing problems, and other serious side effects. Drowsiness, dizziness, lightheadedness, and confusion can increase the risk of falls.
Before having surgery, tell your doctor or dentist about all prescription, over-the-counter, and herbal products you use.
During pregnancy, this medication should be used only when clearly needed. Babies born to mothers who used this medication during the last 3 months of pregnancy may rarely develop symptoms including muscle stiffness or shaking, drowsiness, difficulty feeding/breathing, or persistent crying. If you notice any of these symptoms in your newborn, especially in the first month of life, tell your doctor right away.
Because untreated mental/mood problems (e.g., bipolar disorder, schizophrenia) may cause serious illness, do not stop taking this medication unless directed by your doctor. If you are planning to become pregnant, become pregnant, or think you may be pregnant, discuss the benefits and risks of using this medication during pregnancy with your doctor right away.
This medication passes into breast milk. Please consult your doctor before breastfeeding.
interactive
Drug interactions may change how medications work or increase the risk of serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medications without your doctor's approval.
Products that may interact with this drug are: metoclopramide.
If you are taking other products that cause drowsiness, such as opioid pain or cough medicines (such as codeine, hydrocodone), alcohol, marijuana (cannabis), sleep or anxiety medications (such as alprazolam, lorazepam) pan, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine), tell your doctor or pharmacist.
Check the labels on all your medicines (such as allergy or cough and cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist how to use these products safely.
excess
Do not share this medication with others.
Laboratory and/or medical tests (such as blood sugar, weight, cholesterol/triglyceride levels) may be done before and while you start taking this medication. Keep all medical and laboratory appointments. Please consult your doctor for more details.
Missed dose
If you miss a dose, take it as soon as you remember. If it is near the time of your next dose, skip the missed dose. Take your next dose at your normal time. Don't double your dose just to catch up.
storage
Store tablets and oral solutions at room temperature, away from light and moisture. Oral solutions should be discarded 6 months after opening or after expiration, whichever comes first. Do not store in bathroom. Keep all medicines away from children and pets.
