Aripiprazole: What Is It And What Is It Used For?

Aripiprazole, also known as Abilify, is an atypical antipsychotic. It is an effective and well-tolerated drug. It is used in patients with schizophrenia, bipolar disorder, and manic episodes.

In Europe, it was approved for the treatment of schizophrenia in 2004. Then, in 2008, the European Medicines Agency -EMEA- also authorized its use in bipolar disorder. Especially in type I bipolar disorder.

It is a different drug within its group. And that makes it more interesting. Some of its advantages over other antipsychotics are:

• Less frequency of sedation.
• It does not affect the cognitive function of the patient.
• Lower incidence of adverse effects.
• It can be administered as an intramuscular injection.
• Greater adherence to treatment.

This makes it a widely used drug today. Let’s take a closer look at it.

What is aripiprazole used for?

Aripiprazole is indicated for the treatment of:

• Schizophrenia in adults and adolescents over 15 years of age.
• Manic episodes in patients with bipolar disorder older than 13 years.

Administered orally, it is effective for treating patients with schizophrenia and bipolar disorder. As well as in manic episodes. It works both in the acute phase and in the maintenance phase. It has also been shown to be effective in preventing relapse. Aripiprazole works on both positive and negative symptoms of schizophrenia:

• Positive symptoms : hallucinations, agitation, behavioral disturbance, etc.

• Negative symptoms : flattening, apathy, depression, lack of interest, etc.

An important novelty of this drug are its different forms of administration. These are useful in different situations. In fact, they can be a good alternative for many patients. Thus, intramuscular administration is often used to control agitation in these patients. The extended-release injectable presentation also has positive results in delaying relapses.

This form of administration improves compliance with treatment. With it, it is not necessary to take the drug orally every day; a monthly injection is enough. It is also used together with other drugs to treat depression. For example, in resistant major depressive disorder. The addition of aripiprazole in low doses enhances the effect of the antidepressant drug.

Some studies say that aripiprazole might be helpful in other disorders as well. For example in Alzheimer’s disease. On the one hand, it can help with psychic symptoms. And, on the other hand, in psychotic symptoms. Another case would be Parkinson’s disease. In her the appearance of psychosis is common. In some studies improvement is seen with this drug; but not in others. More studies are still needed to support its use.

Mechanism of action

Aripiprazole is an atypical antipsychotic. However, it has a different mechanism of action. Most of the drugs in its group are dopamine antagonists. In contrast, aripiprazole exerts a partial agonist action on dopamine D2 receptors.

Thus, the increased neurotransmission of dopamine increases its concentration in the brain. And this has a beneficial effect on the positive and negative symptoms of schizophrenia.

It also has a partial agonist effect on serotonin 5HT1A. This action is associated with greater efficiency against:

• Depressive symptoms
• Anxiety.
• Cognitive symptoms.
• Negative symptoms.

In addition, aripiprazole exerts a potent antagonism on the 5HT2A, 5HT2B and 5HT6 serotonin receptors. However, it has a minimal action on other types of receptors.

Side effects

The most common adverse reactions in aripiprazole treatment are:

• Mellitus diabetes.
• Insomnia.
• Anxiety.
• Restlessness.
• Akathisia (psychomotor agitation).
• Extrapyramidal disorder.
• Shaking.
• Headache
• Sedation.
• Drowsiness.

• Dizziness.
• Fatigue.
• Nausea, vomiting, etc.

However, the incidence of adverse effects of this drug is low. Especially if we compare it with other antipsychotics in its group. It is a well tolerated and safe drug. In fact, it is endorsed by various studies.

Aripiprazole treatment is associated with minimal weight gain. And also to a minimal alteration of metabolic parameters. Likewise, there is a low risk of suffering from extrapyramidal symptoms and metabolic syndrome.

Although its profile of adverse effects is very favorable, we must not forget them. It is important to adjust the doses well because adverse effects are more frequent when they increase. You should start with low doses and work your way up little by little.