Aripen

Indications

Aripiprazole is used to treat:

• schizophrenia, a mental illness that can cause hearing or seeing things that are not there, false beliefs and confused thinking;
• manic episodes of bipolar disorder, and to help prevent new manic episodes;
• major depression, added to an antidepressant when the antidepressant alone has not worked well enough;
• irritability linked with autism and tics in Tourette syndrome in children and teenagers, under specialist care.

How It Works

Aripiprazole is an atypical (second-generation) antipsychotic. It balances the activity of two brain chemicals, dopamine and serotonin. It partly stimulates dopamine receptors where activity is too low and partly blocks them where activity is too high, which helps steady mood, thinking and behaviour.

Dosage and Administration

Schizophrenia and bipolar mania, adults: usually 10 to 15 mg once a day, adjusted by the doctor. The maximum is 30 mg a day.

Add-on treatment for depression: a low starting dose, increased slowly, as prescribed.

Children and teenagers: as prescribed by a specialist. Long-acting injections are given into a muscle by a doctor or nurse, usually once a month, as prescribed.

Tablets are taken once a day at the same time, with or without food. It may take a few weeks to feel the full benefit. Do not stop suddenly; the doctor will reduce the dose step by step if it needs to be stopped.

Interactions

• Ketoconazole, Itraconazole, Clarithromycin, Fluoxetine, Paroxetine and Quinidine can raise Aripiprazole levels; the doctor may lower the dose.
• Carbamazepine, Rifampicin and Phenytoin can lower its levels; the dose may need to be raised.
• Alcohol, sleeping pills and other sedating medicines add to drowsiness.
• Blood pressure medicines may cause more dizziness when standing up.
• Other medicines that affect serotonin (some antidepressants, Tramadol) can rarely cause serotonin syndrome.

Contraindications

Do not use Aripiprazole if you are allergic to Aripiprazole or any ingredient of the product.

Side Effects

Common: restlessness or an urge to keep moving (akathisia), shaking, nausea, vomiting, constipation, headache, dizziness, sleepiness or trouble sleeping, blurred vision and tiredness.

Get urgent medical help if you have:

• high fever, stiff muscles, sweating, confusion or a fast heartbeat (neuroleptic malignant syndrome);
• uncontrolled movements of the face, tongue or body;
• thoughts of harming yourself or worsening depression, especially in young people;
• a seizure (fit) or fainting;
• very strong urges you cannot control, such as gambling, shopping, eating or sexual urges;
• severe thirst, passing a lot of urine or signs of high blood sugar;
• swelling of the face or throat or difficulty breathing.

Pregnancy and Lactation

Use in pregnancy only if the doctor decides the benefit outweighs the risk. Babies exposed in the last 3 months of pregnancy may have shaking, stiffness, sleepiness, breathing or feeding problems after birth. Do not stop the medicine on your own if you become pregnant; talk to your doctor. Aripiprazole passes into breast milk; breastfeeding is generally not recommended. Discuss with your doctor.

Precautions and Warnings

• Elderly people with dementia have a higher risk of stroke and death with antipsychotics; Aripiprazole is not approved for dementia-related behaviour problems.
• Tell your doctor if you have heart disease, low or high blood pressure, diabetes, seizures, or a history of stroke or blood clots.
• Blood sugar, weight and cholesterol should be checked from time to time.
• It may cause dizziness or sleepiness; do not drive or use machines until you know how it affects you.
• Avoid overheating and dehydration.
• Avoid alcohol.

Overdose

Symptoms may include extreme sleepiness, vomiting, fast heartbeat, shaking and confusion. Get emergency medical help at once.

Therapeutic Class

Atypical (second-generation) antipsychotic.

Storage

Store below 30°C in a dry place, away from light. Keep out of the reach of children.