Aripiprazole, commonly known by its make name Abilify, is a widely prescribed mental health medication used to treat a variety of mental health situations.
While Abilify can be effective for many, others say, “Its effectiveness has ruined my life.”
The truth is, experiences with medications vary significantly from person to person. What works well for one person may cause uncomfortable or even serious side effects for another.
What is Abilify?
Abilify (aripiprazole) is an atypical antipsychotic medicine approved by the FDA in 2002.
Unlike traditional antipsychotics, Abilify belongs to a new generation of medications designed to have fewer side effects while effectively treating the symptoms of various mental health conditions.
Manufactured by Otsuka Pharmaceutical Co., Abilify is obtainable in various forms, counting tablets, oral solutions, and injectable preparations.
Abilify is considered a significant advance in psychopharmacology due to its unique mechanism of action, which differentiates it after other antipsychotics.
How does Abilify work?
While most antipsychotics primarily block dopamine receptors in the brain, Abilify acts as a partial agonist at some dopamine and serotonin receptors.
This means it can increase or reduction dopamine activity depending on levels in different parts of the brain.
Specifically, Abilify works as:
- A part agonist at dopamine D2 and D3 receptors
- A partial agonist at serotonin 5-HT1A receptors
- A serotonin 5-HT2A receptor antagonist
This unique “dopaminergic system stabiliser” approach allows Abilify to reduce dopamine activity where it is excessive (helping with symptoms like hallucinations and delusions), while potentially increasing dopamine activity in areas where it is deficient (possibly helping with motivation and pleasure). What is Abilify used for?
Abilify is FDA-approved for several mental health conditions:
- Schizophrenia
- Bipolar disorder
- Major depressive disorder
- Irritability associated with autism spectrum disorder (children ages 6 to 17)
- Tourette’s disorder (children ages 6 to 18)
In addition, healthcare professionals sometimes prescribe Abilify off-label for conditions such as:
- Anxiety disorders
- Post-traumatic stress disorder (PTSD)
- Obsessive-compulsive disorder (OCD)
- Dementia-related psychosis (although there are black box warnings about increased mortality in older patients with dementia)
Why do people say, “Abilify ruined my life”?
While Abilify can be helpful for many patients, some have said, “Abilify ruined my life.”
These adverse experiences are often due to:
- Serious side effects: Some people experience debilitating side effects that interfere with their daily lives.
- Tardive dyskinesia: This condition causes involuntary, repetitive movements and can persist even after stopping the medicine.
- Metabolic changes: Significant weight gain, diabetes, and cholesterol problems may occur and persist.
- Impulse control problems: Some patients develop compulsive behaviours such as gambling, shopping, or hypersexuality.
- Withdrawal symptoms: Some people may find it difficult to stop taking Abilify, and withdrawal symptoms can last for weeks or months.
- Emotional flushing: Some patients report feeling emotionally numb or disconnected from their emotions.
- Akathisia: Restlessness and constant need to move can be distressing and difficult to control. It’s important to note that these experiences are not universal, and that Abilify’s ability to ruin the lives of everyone prescribed it isn’t life-threatening.
Many people take Abilify without significant harm and experience substantial benefits for their mental health conditions.
Common Side Effects of Abilify
The side effects of Abilify range from slight to severe and can vary meaningfully from person to person. Common Side Effects:
Most Common Side Effects:
- Headache
- Insomnia or Drowsiness
- Anxiety or Restlessness
- Nausea, Vomiting
- Constipation
- Dizziness
- Weight Gain
- Increased Appetite
- Blurred Vision
- Fatigue
Rare but Serious Side Effects:
- Akathisia: Frequent, distressing feeling of inner restlessness and need to move
- Extrapyramidal Symptoms: Muscle stiffness, tremors, and movement disorders
- Tardive Dyskinesia: Involuntary, repetitive movements that may become permanent
- Neuroleptic Malignant Syndrome: A rare but life-threatening reaction with symptoms including high fever, muscle stiffness, and autonomic instability
- Metabolic Changes: Increased blood sugar, cholesterol, and triglycerides
- Orthostatic Hypotension: Dizziness upon standup due to a drop in blood pressure, Seizures
- Changes in white blood cell count
- Difficulty regulating Body temperature
- Impulse control disorders
If you experience any thoughtful side effects, contact your healthcare breadwinner immediately.
Abilify Types and Doses
Abilify comes in several formulations to meet different patient needs:
Oral Tablets:
Obtainable in 2 mg, 5 mg, 10 mg, 15 mg, 20 mg, and 30 mg fortes. Typically taken once daily with or without food.
Olly Disintegrating Tablets (Abilify Discmelt):
- Available in 10 mg and 15 mg assets. Dissolves on the tongue without water.
- Contains phenylalanine (essential for people with phenylketonuria).
Oral Solution:
- 1 mg/mL strength.
- Helpful for patients with difficulty swallowing tablets.
Injectable Formulations:
- Abilify Maintena: Extended-release monthly injection (300 mg or 400 mg).
- Abilify MyCite: Tablets with a built-in sensor that records when the medication is taken orally. Oral
- Aristada: Extended-release injection lasting 4 to 8 weeks, depending on the patient. Dosage
The dosage varies depending on the disorder being treated, age, other medications, and individual factors. Typical starting doses include:
- Schizophrenia (adults): 10-15 mg daily
- Bipolar disorder (adults): 15 mg daily
- Major depressive disorder (adjunctive treatment): 2-5 mg daily, with the option of increasing
- Irritability associated with autism: 2 mg daily initially, with gradual increases as needed
Always follow your healthcare professional’s specific dosing instructions.
How long does it take to work?
The time it takes to experience the full benefits of Abilify varies depending on the condition being treated and individual factors.
- Acute symptoms (such as anxiety or acute psychosis): Some improvement may be noticed within a few days.
- Schizophrenia symptoms: Initial improvement is seen in 1-2 weeks, and full benefit usually takes 4-6 weeks.
- Bipolar disorder: Manic symptoms may begin to improve in 1-2 weeks.
- Depression: Initial effects are seen in 1-2 weeks, and full benefit usually takes 4-8 weeks.
- Irritability associated with autism: Initial improvement is seen in 1-2 weeks.
It is essential to continue taking Abilify as prescribed, even if you do not notice immediate benefits. Some people may need dose adjustments or a more extended treatment period before achieving optimal results.
How does Abilify make you feel?
Patient experiences with Abilify vary widely:
Positive experiences:
- Reduction in hallucinations, delusions, or paranoia
- Improved mood
- Concentrated irritability
- Improved ability to think clearly
- Better sleep
- Reduced anxiety
- Increased ability to perform daily activities
Negative experiences:
- Sense “zombified” or emotional apathy
- Restlessness or inability to sit still (akathisia)
- Increased anxiety at onset
- Fatigue or tiredness
- Fluid thinking
- Physical discomfort
- Sensation disconnected from oneself
Many patients report positive and negative effects, especially during the initial adjustment period.
While many may begin by saying, “Abilify has ruined my life,” sometimes negative feelings lessen as the body adjusts to the medication. Still, they may persist in other cases and require dosage adjustments or medication changes.
How is Abilify prescribed?
The Abilify prescription process generally includes:
- Comprehensive evaluation: A psychiatrist or other qualified healthcare expert will conduct a thorough assessment of your symptoms, medical history, current medications, and other relevant factors.
- Options analysis: Your healthcare professional should discuss the potential benefits, risks, and alternatives to Abilify.
- Initial prescription: If Abilify is deemed appropriate, your healthcare professional will recommend a starting dose, usually at the low end of the therapeutic range.
- Regular monitoring: You will need regular follow-up appointments to assess the medication’s effectiveness and monitor for side effects.
- Long-term management: Once stabilised, continue regular testing (possibly more frequent) to ensure continued efficacy and safety.
How long does Abilify stay in your body?
Abilify has a relatively long half-life compared to many psychiatric medications:
- The half-life of oral Abilify is approximately 75 hours in adults.
- For Abilify Maintena (the injectable form), the half-life is approximately 29.9 days.
- After discontinuing oral Abilify, it takes approximately 2 weeks for most of the drug to be eliminated from the body.
- The effects of the injectable form may last 1 to 2 months after the last injection.
However, the presence of Abilify in the body is not necessarily associated with experiencing side effects.
Some side effects may disappear sooner, while others (especially side effects such as tardive dyskinesia) may persist even after the drug has been eliminated from the body.
The long half-life of Abilify means that if doses are missed, there is usually no immediate return of symptoms. Still, it also means that side effects may take longer to resolve once the drug is discontinued.
Will I gain weight on Abilify?
Weight gain is a common concern with antipsychotics, including Abilify. However, compared to other antipsychotics, Abilify is considered to pose a lower risk of significant weight gain.
Research suggests:
- About 25% of patients experience a weight gain of 7% or more.
- The average weight gain during long-term treatment is typically 900-2.25 kg.
- Weight gain tends to be more pronounced in younger patients and those who have not taken antipsychotics.
- Patients switching from other antipsychotics to Abilify sometimes experience weight stabilisation or slight weight loss.
Factors that may influence weight changes include:
- Dose
- Duration of treatment
- Individual metabolism
- Dietary and exercise habits
- Other medications are being taken simultaneously
To reduce the possibility of weight gain:
- Monitor your weight regularly
- Maintain a balanced diet
- Engage in regular physical activity
- Consider consulting a dietitian
- Discuss your worries with your healthcare professional, who may recommend metabolic monitoring or medication adjustments as needed.
Abilify and Pregnancy
The use of Abilify during pregnancy requires careful consideration of both the risks and benefits:
- Abilify is classified as Pregnancy Category C by the FDA, sense animal studies have shown adverse effects, but human studies are limited.
- There is no definitive evidence linking Abilify to specific congenital disabilities.
- Severe mental illnesses left untreated during pregnancy also carry significant risks for the mother and baby. Potential Risks:
Some studies suggest possible associations with:
- A slightly increased risk of premature birth
- Low birth weight
- Neonatal withdrawal symptoms may occur if used late in pregnancy
- Potential developmental effects that require further research
Recommendations:
- Pregnant women should not stop taking Abilify without consulting their doctor.
- Pregnancy planning is recommended, allowing for medication adjustments before conception.
- Treatment decisions should be individualised, weighing the mother’s mental health needs against potential risks.
- The lowest effective dose should be used when Abilify is necessary during pregnancy.
- Close monitoring during pregnancy is essential.
- Consult your doctor about breastfeeding while taking Abilify, as the medication passes into breast milk.
Always consult a psychiatrist and obstetrician when treating mental health conditions during pregnancy.
Can Abilify cause depression?
Although Abilify is often prescribed to help treat depression (as an adjunctive treatment), some patients report experiencing new or worsening symptoms, leading to a common saying: “Abilify ruined my life.”
Several factors could explain this apparent contradiction:
- Emotional erosion or numbness that may mimic depression
- Changes in dopamine and serotonin signalling that affect mood
- Worsening of the underlying condition despite treatment
- Side effects such as akathisia are misinterpreted as worsening depression
- Inadequate dosage for the specific condition
Research results:
- Clinical trials show that Abilify generally improves symptoms of depression when combined with antidepressants
- Some studies indicate that a small percentage of patients report an increase in depressive symptoms
Never stop Abilify abruptly due to symptoms of depression, as this can lead to withdrawal symptoms and symptom relapse.
Can Abilify cause compulsive behaviour?
One of the most concerning potential side effects of Abilify is the development of impulse control disorders and compulsive behaviour, another factor that leads people to say, “Abilify ruined my life.”
Research has established links between Abilify and these behaviours, leading to FDA warnings and legal action.
Common compulsive behaviours associated with Abilify include:
- Pathological compulsion
- Compulsive shopping or spending
- Hypersexuality
- Binge eating
- Compulsive internet or video game use
Risk factors that may increase the likelihood of developing these behaviours:
- Personal or family history of impulse control disorders
- Personal or family history of substance use disorders
- Higher doses of Abilify
- Prolonged treatment
- Concomitant medications that affect dopamine
If you are taking Abilify, you must be alert to any new urges or compulsive behaviours and report them to your healthcare professional immediately. Family members should also be informed about this potential side effect so they can help identify changes in behaviour.
Is Abilify addictive?
Abilify is not considered addictive in the old-style sense: it does not produce the euphoria, cravings, or drug-seeking characteristics of addictive substances.
However, prolonged use can lead to physical need on Abilify.
Key Differences:
- Addiction involves compulsive drug use despite its harmful consequences, with cravings and drug seeking.
- Physical dependence involves the body’s adaptation to the drug, resulting in withdrawal symptoms if stopped suddenly.
Abruptly discontinuing Abilify can lead to withdrawal symptoms, indicating that physical dependence has developed. These symptoms may include:
- Insomnia
- Anxiety
- Nausea
- Dizziness
- Recurrence of the original symptoms treated with the drug.
To avoid withdrawal effects, the Abilify dose should always be gradually reduced under medical supervision when discontinuing use.
Signs and Symptoms of Abilify Abuse
While Abilify itself has a low potential for abuse, there are situations where misuse can occur:
Potential situations of misuse:
- Taking a larger dose than prescribed
- Taking it more frequently than prescribed
- Using it without a prescription (often obtained from friends or family)
- Using it with substances of abuse to modify its effects
- Crushing and snorting pills (rare, but reported)
Signs that may indicate Abilify misuse:
- Running out of medication before completing refills
- Requesting prescriptions from multiple providers
- Repeatedly reporting lost or stolen medications
- Changes in behaviour, mood, or physical appearance
- Financial problems related to taking the medication
- Withdrawal symptoms between doses
Consequences of Misuse:
- Increased risk of side effects
- Increased likelihood of severe adverse reactions
- Possible development of tardive dyskinesia
- Metabolic complications
- Cardiovascular problems
If you or someone you know may be misusing Abilify, it is essential to seek help from healthcare professionals who can address both mental health needs and potential substance use issues.
Can you overdose on Abilify?
Although Abilify overdoses are less common than those of other psychiatric medications, they can occur and can be serious:
Overdose symptoms may include:
- Extreme drowsiness
- Rachycardia
- Confusion
- Anxiety
- Difficulty speaking
- Dizziness and weakness
- Seizures
- Respiratory depression (in severe cases)
Overdose Risks:
- Overdoses of pure Abilify without other ingredients are rarely fatal. Combined overdoses (Abilify with alcohol, opioids, or other CNS depressants) are more dangerous.
- People with preexisting heart conditions may be at higher risk for serious complications.
- If you suspect an Abilify overdose, call emergency services (911) immediately or go to the nearest emergency room.
How to stop taking Abilify?
If you think “Abilify has ruined my life,” discontinuing this medication should always be done gradually and under medical supervision.
Stopping Abilify abruptly can lead to withdrawal symptoms and a possible relapse of the condition being treated.
General guidelines for tapering:
- Never stop treatment suddenly: this increases the risk of withdrawal symptoms and rebound effects.
- Work with your healthcare professional to create a personalised tapering program.
- Typical tapering periods range from a few weeks to a few months, depending on:
- How long have you been taking Abilify
- Your current dose
- Your sensitivity
- Your underlying condition
Remember that some people may need a very slow taper, especially after prolonged use at high doses.