Side Effects of Aripiprazole (Abilify)

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. 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 medicine 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.

Muscle Movement Problems

Restlessness. In clinical trials, about 8% of adults with schizophrenia reported akathisia. That’s 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 on aripiprazole than older antipsychotics and some other SGAs. Tardive dyskinesia may stop once you quit your medicine. But sometimes it doesn't go away.

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Metabolic Changes and Weight Gain

Atypical antipsychotics may boost your appetite or change how your body uses energy. This may 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 rare, 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.

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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:

Less Common Side Effects

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

Serious Side Effects

In elderly people. Aripiprazole should not be used to treat dementia-related psychosis in older people. It may make their chances of stroke and death greater. 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, like 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.

What Else You Should Know

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.

If you want to get pregnant, talk to your doctor. It may not be safe for you or your baby for you to stop your schizophrenia treatment. Your doctor can help you decide what to do about your medicine. You should also know that aripiprazole will get into your breast milk. Talk to your doctor before you start breastfeeding.

WebMD Medical Reference Reviewed by Jennifer Casarella on November 13, 2019

Sources

SOURCES:

National Alliance on Mental Illness: “Aripiprazole (Abilify).”

U.S. National Library of Medicine, DailyMed: “Abilify.” 

FDA: “FDA Drug Safety Communication: FDA warns about new impulse-control problems associated with mental health drug aripiprazole (Abilify, Abilify Maintena, Aristada),” “Medication Guide: Abilify.”

Current Neuropharmacology: “The Incidence of Akathisia in the Treatment of Schizophrenia with Aripiprazole, Asenapine and Lurasidone: A Meta-Analysis.”

CNS Drugs: “Aripiprazole and Acute Extrapyramidal Symptoms in Children and Adolescents: A Meta-Analysis,” “Antipsychotic Drug-Induced Somnolence: Incidence, Mechanisms, and Management.”  

Clinical Psychopharmacology and Neuroscience: “Tardive Dyskinesia: Treatment with Aripiprazole.”

Pharmacy and Therapeutics: “Aripiprazole (Abilify) and Tardive Dyskinesia.”

Neuropsychiatric Disease and Treatment: “Antipsychotic-associated weight gain: management strategies and impact on treatment adherence.”

European Journal of Clinical Pharmacology: “Efficacy and safety of aripiprazole for the treatment of schizophrenia: an overview of systematic reviews.”

Schizophrenia Research: “Head-to-head comparisons of metabolic side effects of second-generation antipsychotics in the treatment of schizophrenia: a systematic review and meta-analysis.”

European Child & Adolescent Psychiatry: “Efficacy and safety of aripiprazole in child and adolescent patients.”

Journal of the Canadian Academy of Child and Adolescent Psychiatry: “Focus on aripiprazole: A review of its use in Child and Adolescent Psychiatry.”

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