Abilify (aripiprazole): uses, side effects, and what to expect

If you or your psychiatrist are considering aripiprazole, you likely have questions about how it works and what to expect. Abilify (aripiprazole) is an atypical antipsychotic used to treat schizophrenia, bipolar disorder, and major depressive disorder. Talkiatry psychiatrists prescribe aripiprazole as part of individualized treatment plans for several of these conditions.

Key takeaways

• Abilify (aripiprazole) is an atypical antipsychotic approved to treat schizophrenia, bipolar disorder, major depressive disorder (as an add-on), irritability in autism spectrum disorder, and Tourette syndrome in children.¹
• Aripiprazole works as a partial agonist at dopamine and serotonin receptors, meaning it can increase or decrease activity depending on what the brain needs.²
• It may take two weeks or longer to feel the full benefit of aripiprazole.¹
• Some people experience akathisia, a feeling of inner restlessness, which should be reported to a clinician promptly.

What is Abilify?

Abilify is the brand name for aripiprazole, a medication in the atypical antipsychotic class. It is prescribed for a range of psychiatric conditions, from schizophrenia and bipolar disorder to treatment-resistant depression. Aripiprazole is available in tablet, liquid, orally disintegrating tablet, and oral film forms.¹

What does Abilify treat?

Aripiprazole is FDA-approved for several conditions. You can learn more about medications used to treat bipolar disorder on the Talkiatry blog.

On-label uses

• Schizophrenia
• Bipolar disorder (manic and mixed episodes)
• Major depressive disorder (adjunct treatment)
• Irritability associated with autism spectrum disorder
• Tourette syndrome (in children)¹

How does Abilify work?

Aripiprazole acts as a partial agonist at dopamine and serotonin receptors. Think of it like a thermostat: it dials activity down when it's too high and nudges it back up when it's too low. This helps stabilize mood and behavior.²

• Helps balance dopamine and serotonin activity. Aripiprazole works as a partial agonist at certain dopamine and serotonin receptors, meaning it can either increase or decrease activity depending on what the brain needs.²
• Supports more stable mood and thinking patterns. By regulating these key neurotransmitters, it can reduce symptoms of psychosis, mania, and severe mood disturbances.
• Promotes emotional steadiness over time. With consistent use, aripiprazole can help reduce extreme mood shifts, agitation, and irritability.

3 things a Talkiatry psychiatrist wants you to know about Abilify

• It's used for several different conditions. Aripiprazole is approved for schizophrenia, bipolar disorder, depression (as an add-on), autism-related irritability, and Tourette syndrome. That breadth means your psychiatrist has flexibility to keep you on one medication even if your diagnosis evolves over time.
• It tends to be activating. Aripiprazole is often more activating than sedating, which can matter for people who find drowsiness interferes with daily life.
• Restlessness can occur, and it's manageable. Some people feel an inner urge to move or have trouble sitting still, called akathisia. If this happens, your psychiatrist can often address it by adjusting the dose or adding a short-term medication to ease the sensation.

Common side effects of Abilify

Like all medications, aripiprazole can cause side effects. Most are mild and may improve as your body adjusts.¹

• Headache
• Nervousness or restlessness
• Dizziness, unsteadiness, or balance difficulties
• Heartburn, constipation, diarrhea, or stomach pain
• Weight gain or appetite changes
• Increased saliva production
• Pain in the arms, legs, or joints
• Tiredness

Talk to your psychiatrist if any of these feel persistent, severe, or get in the way of your day.

Serious side effects of Abilify and when to seek help

Serious side effects are less common, but it is important to know what to watch for.¹

• Allergic reactions such as rash, hives, swelling of the face, mouth, lips, tongue, or throat, or difficulty breathing or swallowing
• Seizures
• Uncontrollable movements of the face, tongue, or other body parts (tardive dyskinesia)
• Neuroleptic malignant syndrome: fever, stiff muscles, sweating, confusion, and fast or irregular heartbeat
• Increased falls or coordination problems
• Tightening of the neck muscles or throat tightness
• Extreme thirst, frequent urination, extreme hunger, blurred vision, or weakness may signal high blood sugar (hyperglycemia), which can progress to a life-threatening condition called ketoacidosis if untreated
• Compulsive behaviors such as gambling urges, increased sexual urges, excessive shopping, or binge eating
• Children, teenagers, and young adults taking antidepressants may have increased suicidal thoughts, especially early in treatment or after dose changes
• Older adults with dementia-related psychosis face a higher risk of death and stroke when treated with antipsychotic medications; aripiprazole is not FDA-approved for dementia-related behavior problems

Call your psychiatrist right away or seek emergency care if you experience any of these symptoms.

What to watch for when starting Abilify

Starting a new medication comes with an adjustment period. Here is what to keep in mind with aripiprazole.¹

• Give it time. It may take two weeks or longer to feel the full benefit.
• Watch for drowsiness. Aripiprazole may cause drowsiness; avoid driving or operating machinery until you know how it affects you.
• Avoid alcohol. Alcohol may increase drowsiness and should be avoided while taking aripiprazole.
• Stand up slowly. Dizziness, lightheadedness, or fainting can occur when standing up too quickly, especially early in treatment. Get out of bed slowly and rest your feet on the floor before standing.
• Be cautious in the heat. The medication may make it harder for your body to cool down in extreme heat, and it may increase your risk of sunburn. Take precautions during vigorous exercise or hot weather.
• Don't stop on your own. Continue taking aripiprazole even if you feel well. Do not stop without talking to your clinician.

What to do if you miss a dose of Abilify

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue your regular schedule. Do not take a double dose to make up for a missed one.¹

Who should talk to a psychiatrist before taking Abilify

Some health conditions, medications, and life situations change how Abilify is prescribed. Tell your psychiatrist if any of the following apply to you.¹

• You have allergies to aripiprazole or any of its ingredients
• You have heart disease, heart failure, a history of heart attack, irregular heartbeat, high or low blood pressure, or a history of stroke or ministroke
• You have a history of seizures
• You have low white blood cell count or high cholesterol
• You have diabetes or a family history of diabetes, since aripiprazole may increase blood sugar levels
• You have a personal or family history of substance misuse, impulse-control disorder, bipolar disorder, obsessive-compulsive disorder, or an impulsive personality
• You have previously stopped a psychiatric medication due to severe side effects
• You have difficulty swallowing or balance problems
• You have severe diarrhea, vomiting, or are dehydrated
• You are pregnant, planning to become pregnant, or breastfeeding; aripiprazole may cause problems in newborns if taken in late pregnancy
• You have phenylketonuria (PKU), since the orally disintegrating tablets contain phenylalanine
• You are taking St. John's wort
• You regularly consume grapefruit juice, which may affect how your body processes Abilify