Aripiprazole Side Effects

Medically Reviewed by Poonam Sachdev on June 12, 2024
Written by Keri Wiginton, Shawna Seed
9 min read

If you have schizophrenia, your doctor may want you to take aripiprazole. That’s a prescription drug sold under the brand name Abilify.

Aripiprazole is an atypical or second-generation antipsychotic (SGA). It balances out your dopamine and serotonin levels. These are chemicals in your brain that affect how you think, feel, and act. Your thoughts may become clearer on this drug. You may stop hearing or seeing things that aren’t there, and your mood and motivation may get better.

Oral forms of the drug can also treat Tourette’s syndrome and symptoms of bipolar 1 disorder. Aripiprazole may help calm irritability in children and teens with autism. Your doctor may use it with other medicines to treat depression. You can get a shot of aripiprazole to treat agitation with schizophrenia or bipolar mania.

Aripiprazole can help your mind become more stable. But like any drug, it can cause unwanted side effects. Some are mild, but others can be serious. Talk to your doctor about what can happen if you or your child take this medicine.

You should take aripiprazole at the same time every day. Read the patient information that comes with the drug and follow the directions that come with the medicine carefully. If you're not sure about something, ask your doctor or pharmacist.

Don't skip doses or take more than your doctor has prescribed. If you miss a dose, take it as soon as you remember. If it's almost time for your next dose, take that dose but don't double up.

It may take a few weeks for you to feel any effects. Even if you think it isn't working, don't stop taking aripiprazole without talking to your doctor.

Muscle movement problems

This drug might cause side effects that impact your muscles. 

Restlessness. In clinical trials, about 8% of adults with schizophrenia reported akathisia — a movement disorder that makes it hard to stay still. You may feel like you need to do something with your legs. You may want to pace or rock back and forth. It feels different than agitation or anxiety.

Extrapyramidal symptoms (EPS). If you’re younger than 20, you’re more likely to have muscles that move or twitch on their own. A review of 41 studies showed about 17% of young people on aripiprazole get EPS.

Symptoms of EPS include:

  • Repeated muscle contractions (dystonia)
  • Urge to move around (akathisia)
  • Body parts that shake (tremor)
  • Inability to bend (Parkinsonism)

Tardive dyskinesia. This is a disorder where you can’t control the muscles in your tongue, mouth, face, and upper body. It can happen after you use antipsychotics for a long time. You’re more likely to get it if you have other medical or movement problems. But your chances may be lower with aripiprazole than with older antipsychotics and some other SGAs. Tardive dyskinesia may stop once you quit your medicine. But sometimes, it doesn't go away.

Metabolic changes and weight gain

Atypical antipsychotics may boost your appetite or change how your body uses energy. This can lead to weight gain. Sometimes, these drugs can raise your blood sugar or cholesterol levels. That can make it more likely that you’ll have diabetes and heart disease.

But when compared to similar drugs, aripiprazole may lead to less weight gain and problems with your metabolism.

Children on SGAs are more likely to gain weight than adults, especially if they have schizophrenia or autism. But adolescents who take aripiprazole may gain less weight than kids on other antipsychotics.

Your doctor may want to keep an eye on your or your child’s weight. They may want to watch your glucose and cholesterol levels, too. In the meantime, make sure you eat a balanced diet and get plenty of exercise.

Desire to sleep

Aripiprazole can make you tired. Somnolence, or a strong urge to sleep, is more common in children. The effects may be higher with bigger doses. But aripiprazole may cause less somnolence than similar drugs. It may go away with time.

Compulsive behavior

It’s a rare side effect, but you may get an urge to gamble that you can’t resist. Less often, you may feel the need to have sex, shop, or eat in a way you can’t control. If your loved one acts like this, you may need to tell them. They may not know it’s not normal.

These urges usually go away when your doctor lowers your dosage or stops the medicine. But always talk to your doctor before you quit aripiprazole.

Neuroleptic malignant syndrome (NMS)

Rarely, this drug can cause a possibly fatal set of symptoms. NMS can affect your heart, muscles, and kidneys. You may also get:

If you have any of these symptoms, check with your doctor right away. They’ll want to rule out other medical conditions first. If your medicine is the problem, you’ll stop taking aripiprazole right away. You’ll get treatment for your other symptoms.

Other common side effects

In clinical trials, at least 10% of all adults (including those without schizophrenia) also had:

At least 10% of all children and young adults (including those without schizophrenia) also had:

Some people may have drooling or get blurry vision, dry mouth, or a rash.

In elderly people. Aripiprazole should not be used to treat dementia-related psychosis in older people. It may raise their chances of stroke and death. The drug may make elderly people sleepy and lightheaded. They may not be able to swallow easily. This may raise their chances of injuries from falls or choking.

In young people. Antidepressants may raise the chances of suicidal thoughts in people younger than 24. If you care for a child or teenager on antidepressants, watch them closely for changes in their behavior. This is even more important during the first few months of treatment or if their dose changes. If you get worried, talk to your doctor.

After you start aripiprazole

Don’t drink alcohol or use illegal drugs when you take aripiprazole. Your medicine may not work as well if you do. You may also have worse side effects, such as sleepiness.

Don’t operate machines or drive until you know how you’ll react to aripiprazole. Since it makes you drowsy, you may be more likely to have an accident. You may fall and hurt yourself if you’re tired.

You should tell your doctor if you exercise a lot or if you’re going to be somewhere that’s hot. That’s because the medicine may make it harder for your body to cool off. You should make sure to drink enough water.

When to seek emergency treatment

You should see your health care provider regularly while you take aripiprazole, especially when you first start the medication.

If you suspect an aripiprazole overdose, call the national poison control helpline at 1-800-222-1222. You also can find information on the poison center website: https://www.poisonhelp.org/help.

You should call 911 right away if the person:

  • Has collapsed
  • Had a seizure
  • Is having trouble breathing
  • Can't wake up

Signs that someone has taken too much aripiprazole include:

  • Drowsiness
  • Weakness
  • Enlarged pupils
  • Nausea
  • Vomiting
  • Uncontrolled movements
  • Confusion
  • Seizure
  • Unconsciousness

Your mental health could change in ways you don't expect while taking this drug, especially in the beginning. You could become suicidal when you first start taking it, or any time your dose is changed. You, a family member, or a caregiver should call your doctor right away if you experience any of these symptoms:

  • Depression that's new or gets worse
  • Thoughts of self-harm or suicide
  • Planning or attempting self-harm or suicide
  • Extreme worry
  • Agitation
  • Panic attacks
  • Trouble sleeping
  • Irritability
  • Aggressive behavior
  • Compulsive behavior
  • Severe restlessness
  • Frenzied, abnormally excited mood (mania)

Aripiprazole also could cause a dangerous allergic reaction. Seek help right away if you experience:

  • Hives
  • Rash
  • Swelling of face, mouth, lips, tongue, throat, hands, feet, ankles, or legs
  • Itching
  • Trouble breathing or swallowing
  • Vision changes
  • Uncontrollable shaking of your face, tongue, or other parts of your body
  • Throat tightness

Aripiprazole and sexual health

Antipsychotic medicines can have sexual side effects. Among the most common are: 

  • Loss of sexual interest (low libido)
  • Erectile dysfunction and difficulty ejaculating
  • Menstrual problems

However, aripiprazole may be less likely to cause these problems than other antipsychotic drugs.

Who shouldn't take aripiprazole?

You shouldn't take aripiprazole if you already take any of these medications:

  • Brexpiprazole
  • Cisapride
  • Dextromethorphan; quinidine
  • Dronedarone
  • Metoclopramide
  • Pimozide
  • Quinidine
  • Thioridazine

Drug interactions

Many medicines and supplements -- both prescription and over-the-counter (OTC) -- can interact with aripiprazole. Make sure your doctor knows about everything you take, including OTC medicines and supplements. Among those that might interact with aripiprazole are:

  • Antihistamines
  • Anxiety and sleep medicines
  • Some antidepressants
  • Some drugs that fight fungal infections
  • General anesthetics
  • Parkinson's drugs such as levodopa
  • Blood pressure medications
  • Antiseizure drugs
  • Narcotic pain medications
  • St. John's Wort

Food interactions

Grapefruit juice may interact with aripiprazole. Check with your doctor about whether you should avoid it.

Pregnancy and breastfeeding

If you're breastfeeding, pregnant, or planning to become pregnant, tell your doctor. It's especially important to let your doctor know if you're in the last few months of pregnancy. Aripiprazole could cause a problem for your baby after delivery if you take it toward the end of your pregnancy. The effects of aripiprazole when you're breastfeeding haven't been studied enough to give definitive safety information. You'll need to discuss it with your doctor and weigh the pros and cons of taking the medication while nursing.

Allergies

If you have allergies, make sure your doctor has complete information about them. Some people could be allergic to ingredients in aripiprazole.

Other conditions

If you're having surgery, including dental surgery, let your surgeon or dentist know that you take aripiprazole.

Your side effects may go away with time. But tell your doctor if you have any symptoms that you can’t control. They’ll help you figure out if you need to lower your dose or quit taking the drug.

Even if you feel better, don’t stop taking your medicine. You’ll need ongoing treatment for your schizophrenia. And your symptoms may come back if you miss a dose. If you want to change or stop your medicine, talk to your doctor. They’ll let you know when it’s safe to adjust your aripiprazole.

 

Aripiprazole, sold under the brand name Abilify, is a drug that's used to treat schizophrenia. It works by balancing out chemicals in your brain. It's also used for Tourette's syndrome and bipolar disorder. It can be used to calm agitation in children and teens with autism. Aripiprazole carries the risk of certain side effects; however, the risk may be lower than that of previous generations of antipsychotic drugs. It's important to read all the patient information and make sure you and those close to you know what to expect when you take this drug and what to watch out for.

What's the most common side effect of Abilify?

The most common side effects are:

  • Headache
  • Trouble sleeping
  • Feeling anxious or restless
  • Nausea, vomiting, and indigestion
  • Constipation
  • Feeling sleepy

How long do Abilify side effects last?

Some side effects will go away as your body adjusts to the medicine. If they don't go away, or if they're hard to manage, talk to your doctor. They may want to adjust your dose.

What are the long-term effects of Abilify?

Conditions such as schizophrenia and bipolar disorder require long-term treatment.

One risk of using antipsychotic drugs long-term is tardive dyskinesia, a movement disorder that can affect your speech. But studies have shown that aripiprazole has a lower risk of this side effect than other antipsychotic drugs. Other risks from long-term use include:

  • Diabetes
  • Weight gain
  • High cholesterol
  • High triglycerides

Does Abilify interact with other medications?

Aripiprazole can interact with many prescription medications and over-the-counter drugs such as antihistamines. It's important to let your doctor know about all the medications and supplements you take.