Aripiprazole is a commonly prescribed antipsychotic you might see under the brand name Abilify. People use it for schizophrenia, bipolar disorder, and as an add-on for depression. It works differently from older antipsychotics: instead of fully blocking dopamine, it balances dopamine activity. That difference can mean fewer sedating effects for many people.
Aripiprazole comes as tablets, an oral solution, and long-acting injections. Typical starting doses vary: for adults with schizophrenia the usual start is 10–15 mg once daily. For bipolar mania dosing can be similar. As an add-on for major depression doctors often start lower and adjust slowly. Long-acting injectables (Abilify Maintena, aripiprazole lauroxil) are given monthly by a healthcare provider and can help when daily pills are missed.
Don’t stop suddenly. Stopping quickly can bring back symptoms or cause withdrawal-like effects. If you want to stop, ask your prescriber for a taper plan. Missing doses? If you remember the same day, take it. If not, skip and return to your usual schedule — don’t double up.
Most people tolerate aripiprazole, but some side effects are common: restlessness or akathisia (that inner need to move), anxiety, insomnia, nausea, and occasional dizziness. Some people notice weight gain or changes in appetite. Unlike some older antipsychotics, aripiprazole often causes less sedation, but metabolic changes can still occur.
Call your doctor right away for serious signs: high fever, stiff muscles, confusion, very fast heartbeat, fainting, or sudden mood changes like new suicidal thoughts. Also seek help for severe involuntary movements (tardive dyskinesia). Older adults with dementia-related psychosis have a higher risk of death on antipsychotics — aripiprazole should not be used for dementia-related behavior problems.
There are important drug interactions. Aripiprazole is processed by CYP2D6 and CYP3A4. Strong inhibitors like fluoxetine, paroxetine, or fluconazole can raise aripiprazole levels and may need dose cuts. Strong inducers such as carbamazepine or rifampin can lower levels and might require dose increases. Tell your prescriber about all medicines and supplements you take.
Practical checks: before you start, get baseline weight, blood sugar, and lipids. Repeat these tests periodically. Keep a symptom diary for the first few weeks — note mood, sleep, restlessness, and any new symptoms. If you feel akathisia, low-dose beta blockers or changing dose/timing often helps, but check with your clinician first.
Pregnancy and breastfeeding: there’s limited data. If you’re pregnant or planning pregnancy, discuss risks and benefits with your doctor. Many people stay on treatment when benefits outweigh risks, but this needs an individualized plan.
Short, practical tip: keep communication open with your prescriber, report side effects early, and use injectable options if pill adherence is a problem.
