Using Abilify for Treatment of Bipolar Disorder

Abilify, known by the generic name aripiprazole, is an atypical antipsychotic medication that is approved to treat a number of disorders, including bipolar disorder. It's used specifically to treat manic and mixed episodes in bipolar disorder, either alone or in combination with other anti-manic medications.

What Is Abilify Used to Treat?

Abilify is approved to treat the following health conditions:

• Schizophrenia in people aged 13 or older
• Bipolar I disorder in people aged 10 or older
• Major depressive disorder in adults (used in combination with another antidepressant when a person does not respond to that single antidepressant)
• Agitation associated with schizophrenia or bipolar mania
• Agitation associated with autism spectrum disorder in children ages 6 to 17
• Tourette syndrome in children and adolescents ages 6 and older

Common Abilify Side Effects

In adults, common side effects include:

• Akathisia
• Anxiety
• Blurred vision
• Constipation
• Dizziness
• Fatigue
• Headache
  
• Insomnia
• Nausea

Side effects in children are similar, with the addition of nose congestion, drooling, and changes in appetite.

Potential Serious Abilify Side Effects

Abilify may cause serious side effects, like:

• Change in cholesterol levels
• Difficulty swallowing
• Increase in blood sugar
• Leukopenia, neutropenia, and agranulocytosis, which cause severe and dangerous decreases in white blood cell count, have also been reported and are potentially fatal
• Neuroleptic malignant syndrome, which is a potentially fatal complication characterized by symptoms like high fever, rigid muscles, and rapid swings in blood pressure
• Orthostatic hypotension, or feeling lightheaded when moving from a ​lying or sitting position to a standing position too quickly, due to a drop in blood pressure
• Seizures
  
• Tardive dyskinesia, which is a disorder that causes uncontrolled facial and other movements
• Weight gain

Impulse-control problems including pathological gambling, compulsive shopping, and compulsive eating may also occur. In such cases, your prescribing doctor may recommend reducing your dose or discontinuing the medication. 

Considerations When Taking Abilify

Speak to your prescribing doctor right away if you are planning on getting pregnant or are pregnant. Animal studies suggest that Abilify may be harmful to the fetus, but it's not clear if that risk applies to humans. Your doctor can help you determine whether the benefits of taking Abilify outweigh any potential problems.

Other important warnings include:

• Do not drink alcohol while you are taking Abilify.
• Avoid overheating and dehydration while on Abilify.
• Abilify may also pass into breast milk, so be sure to discuss your therapy plan if you are breastfeeding or planning on breastfeeding.

Abilify Withdrawal

You may experience withdrawal symptoms if you stop taking Abilify suddenly. While withdrawal was not observed in studies on the medication, some people have reported symptoms as a result of sudden discontinuation. 

Because withdrawal appears to be uncommon, the exact symptoms and timeline are not well understood. If you do quit taking your medication abruptly, you might experience nausea, increased heart rate, fever, headache, body aches, and sweating.

To avoid potential withdrawal symptoms, your doctor may recommend gradually tapering your dose. You should also discuss what other medications or strategies you will use to manage your condition once you stop taking Abilify.

Drug Interactions With Abilify

Abilify may also interact with other medications. Some medications that may interact with Abilify include:

• Biaxin (clarithromycin), an antibiotic
• Antidepressants including Prozac (fluoxetine) and Paxil (paroxetine)
• Antifungals including Diflucan (fluconazole), Nizoral (ketoconazole), and Sporanox (itraconazole)
• HIV medications, including Crixivan (indinavir) and Kaletra (lopinavir/ritonavir)
• Quinidine, an antiarrhythmic

Tegretol (carbamazepine) and Rifadin (rifampin) may lower the effectiveness of Abilify. 

Warnings About Abilify

Black box warnings are included on medications when they have the potential to cause serious, life-threatening side effects. Abilify carries two black box warnings from the FDA:

• Increased mortality in elderly patients with dementia-related psychosis: Abilify is not FDA-approved to treat people with dementia-related psychosis, although it is sometimes used for this purpose. Treating older adults with dementia-related psychosis with an antipsychotic medication puts them at a somewhat increased risk of death.
• Suicidality and antidepressant drugs: Although it is not an antidepressant, Abilify carries the standard warning that antidepressants may increase the risk of suicidal thoughts and behavior in children, adolescents, and young adults.