Abilify dosage, forms, and strengths

Abilify is a brand-name prescription drug (generic name: aripiprazole) used to treat schizophrenia, bipolar I disorder, major depressive disorder, and, in pediatric patients, autistic disorder and Tourette’s disorder. Aripiprazole, the active ingredient in Abilify, is an atypical antipsychotic that calms brain activity by balancing the neurotransmitters dopamine and serotonin in specific areas of the brain. By balancing neurotransmitter activity in select brain regions, it can lessen symptoms of schizophrenia, mania, Tourette’s, and autistic disorder. Because the drug is highly selective in its effects on the brain, certain side-effects such as metabolic problems and involuntary movement disorders are more mild when compared with earlier generation antipsychotics. Abilify is normally taken as a tablet with or without food, but there is a once-monthly bipolar maintenance injection sold under the brand name Abilify Maintena.

RELATED: What is Abilify | Get Abilify discounts

Abilify forms and strengths

Abilify is taken as a tablet or, as Abilify Maintena, a once-monthly injection. For other formulations, generic aripiprazole also comes as an orally disintegrating tablet or oral solution.

• Tablets: 2 milligrams (mg), 5 mg, 10 mg, 15 mg, 20 mg, 30 mg

Abilify dosage for adults

In adults, Abilify is FDA-approved to control the symptoms of schizophrenia, treat manic or mixed episodes in people with bipolar disorder, and as an add-on to antidepressants in the treatment of major depressive disorder. Healthcare providers may, however, use Abilify to treat other psychiatric disorders such as dementia. 

Source: Epocrates

Abilify dosage for schizophrenia

Abilify is prescribed to treat schizophrenia, a psychiatric disorder characterized by unreal perceptions, false beliefs, disorganized thinking, and other symptoms. Abilify helps manage schizophrenic symptoms by balancing the neurotransmitter dopamine in the parts of the brain responsible for the positive symptoms of schizophrenia (like hallucinations), the negative symptoms (such as lack of interest), and problems with thinking. 

• Standard dosage for schizophrenia in adults: 10–15 mg taken once per day

• Maximum dosage for schizophrenia in adults: 30 mg per day (tablets) or 25 mg per day (oral solution).

Abilify dosage for the acute treatment of bipolar mania or mixed episodes

People with bipolar I disorder experience cyclic but severe changes in mood that alternate between depressive episodes and extremely excited and energized episodes, called mania. Some people may experience both depression and mania at the same time in what healthcare professionals call a mixed episode. 

Abilify may be prescribed when a person is experiencing an acute manic or mixed episode of bipolar I disorder. It can also be prescribed for regular use (maintenance treatment) in patients with bipolar I disorder, even while they are not experiencing an episode. Using Abilify between episodes can help delay the onset of future episodes. As with schizophrenia, aripiprazole modulates brain activity by blocking the effects of dopamine, a chemical that passes signals between nerves. For the treatment of manic or mixed episodes, Abilify can be prescribed alone (monotherapy) or combined with mood stabilizers such as lithium or valproate.

• Standard dosage for bipolar mania or mixed episodes in adults: 15 mg taken once daily as monotherapy or 10–15 mg taken once per day when taken with lithium or valproate

• Maximum dosage for bipolar mania or mixed episodes in adults: 30 mg per day (tablets) or 25 mg per day (oral solution).

Abilify dosage for the adjunctive treatment of major depressive disorder

Abilify is also used as an adjunctive (add-on) treatment for people diagnosed with major depressive disorder (MDD) who are also taking antidepressants. MDD is a common medical condition characterized by symptoms of depression that last for two weeks or more. Abilify is commonly prescribed in people who are not responding to antidepressant treatment alone. Researchers are uncertain why Abilify is successful as an MDD augmentation therapy, but they believe it is related to its effects on serotonin and dopamine receptors in the brain’s nerve cells.

• Standard dosage for adjunctive treatment for major depressive disorder in adults: 2–15 mg taken once per day

• Maximum dosage for adjunctive treatment for major depressive disorder in adults: 15 mg per day 

Abilify dosage for children

Abilify is prescribed for children and adolescents to treat schizophrenia, bipolar I disorder, Tourette’s syndrome, and to reduce irritability in children diagnosed with autistic disorder. Approved age ranges vary by condition, but some healthcare providers may prescribe Abilify off-label to children who fall outside this age range. Healthcare providers will always start with a low dose which may be steadily increased until an effective dose is reached.

Source: Epocrates

Abilify dosage restrictions

Abilify dosage adjustments are required in people whose livers do not break down the drug very quickly. Called “poor CYP2D6 metabolizers” after the liver enzyme responsible for breaking down certain medications (including aripiprazole), these people will be given half the normal dose. No dose adjustments are required for people with liver or kidney problems.

Some people may not be able to take Abilify because of possible risks. Abilify is not prescribed to people who have serious allergic reactions to the drug or its inactive ingredients. 

The injectable form of Abilify is not approved for use in patients less than 18 years of age.

Because of the increased risk of death, healthcare providers will be cautious about using the drug in elderly patients with dementia-related psychosis. 

Various health conditions may warrant cautious use of Abilify due to its side effects. Examples include patients with cardiac conditions, autoimmune diseases, cerebrovascular disease, seizure disorders, blood diseases, difficulty swallowing (dysphagia), diabetes, high cholesterol, high triglycerides, obesity, and neurological diseases. This is not an exhaustive list of conditions that warrant careful use of Abilify. Patients with these conditions must be monitored carefully due to Abilify’s ability to worsen these conditions or cause greater side effects when taken by patients with these conditions.

Finally, due to the increased risk of suicide among children and young adults after taking antidepressant medications, Abilify may need to be replaced with a different treatment option in patients who are demonstrating suicidal thinking or worsening depression. 

How to take Abilify

Abilify is taken by mouth as a tablet once per day. The daily dose can be taken with a meal or on an empty stomach.

• When taking Abilify, follow the instructions given by the prescribing healthcare provider. Do not change the dose prescribed.

• This medicine should come with a medication guide. The guide provides valuable instructions for taking, storing, and using this medicine, so please read it when each month’s prescription is filled.

• Swallow the Abilify tablet whole with a glass of water. Do not crush, break, divide, or chew the tablet.

• Do not stop taking Abilify unless directed by a healthcare professional.

• Store Abilify tablets and Abilify oral solution at room temperature (68°F to 77°F) out of the reach of children.

• Opened bottles of Abilify oral solution can be used for up to 6 months after opening, but not beyond the expiration date on the bottle. 

A healthcare provider may prescribe Abilify Mycite tablets instead of regular tablets. These tablets, prescribed only to adults who are not medication-compliant, come with a sensor in each tablet, a wearable patch to read the tablet’s sensor, and a smartphone app to record sensor data. The goal is to make sure patients are taking their medication as prescribed. A healthcare provider will show patients how to wear the patch, download the smartphone app, and how to take these tablets. It is important to realize that after a tablet is taken the sensor may not detect the tablet immediately. Sometimes the sensor won’t detect the tablet at all. Do not take a second dose if the tablet’s sensor is not detected by the patch.

Abilify dosage FAQs

How long does it take Abilify to work?

While oral aripiprazole is absorbed quickly into the bloodstream, it may take two weeks to notice substantial improvements in symptoms. This is when concentrations of aripiprazole reach a steady state in the body. This is also the reason that dose adjustments should not be made more frequently than every two weeks. Symptoms will continue to improve after a two-week period and it may take a few months to realize the full benefit of taking Abilify.

Extended-release injectable aripiprazole has a much longer half-life than oral aripiprazole. For this reason, Abilify Maintena should only be prescribed after patients have reached an effective dosing regimen of oral aripiprazole.

What happens if I miss a dose of Abilify?

Take a missed dose as soon as it’s remembered unless it’s nearly time for the next dose. In that case, skip the missed dose and take the next dose at its scheduled time. Never take extra medicine or a double dose to make up for a missed dose.

How long can you take Abilify?

How long Abilify is taken depends on the condition being treated. Schizophrenia is a lifelong psychiatric disorder requiring lifelong treatment. Abilify will be prescribed as long as it works and the side effects are manageable. If a doctor prescribes Abilify to treat an acute bipolar episode, Abilify may be discontinued after symptoms of the episode have been controlled. If Abilify is prescribed as a maintenance treatment for bipolar I disorder, it is likely to be continued as long as it is tolerable and effective. However, for all indications, healthcare providers are urged to continually reassess the need for Abilify and discontinue the medicine if possible.

How do I stop taking Abilify?

The sudden discontinuation of Abilify may cause withdrawal symptoms in some patients. It’s best to stop taking Abilify only under the medical advice of a healthcare professional.

There are many reasons people may need to stop taking Abilify. Serious side effects such as severe allergic reactions, stroke, neuroleptic malignant syndrome, high cholesterol, high blood sugar, high blood pressure, fast or slow heart rate, orthostatic hypotension, suicidal thoughts, or worsening of depression may require the drug to be immediately discontinued if any of these become clinically significant problems. In some cases, people will be taken off Abilify if it causes involuntary movement disorders. Called extrapyramidal symptoms or EPS, these include involuntary grimacing (tardive dyskinesia), muscle stiffness, or uncontrollable restlessness (akathisia). Finally, some people may find it hard to tolerate common but less serious adverse effects such as sedation, weight gain, blurred vision, constipation, or problems with body temperature regulation.

If Abilify cannot be taken, people with schizophrenia can turn to a wide range of antipsychotic drugs. People with bipolar disorder can switch to another antipsychotic or a mood stabilizer such as lithium or carbamazepine. People with MDD on an antidepressant such as Paxil (paroxetine) or Prozac (fluoxetine) can turn to other effective antipsychotic augmentation treatments such as Zyprexa (olanzapine), Seroquel (quetiapine), or Risperdal (risperidone). The combination drug Symbyax combines both olanzapine and fluoxetine for people with treatment-resistant depression. 

What interacts with Abilify?

As with all prescription drugs, taking Abilify with other drugs might cause problems. It’s a good idea to carry a current list of all medications being taken including prescription drugs, over-the-counter medicines, and even supplements. To avoid potentially harmful drug interactions, always share this list with healthcare providers when getting a prescription. 

Abilify’s most significant drug interactions involve drugs that affect the body’s metabolism of aripiprazole. Drugs like aripiprazole are broken down by specific enzymes in the liver. Some drugs block the enzymes that break down aripiprazole. If they’re taken with Abilify, aripiprazole concentrations in the blood will go up, increasing the risk and severity of side effects. The most powerful drugs that block the metabolism of Abilify include some antibiotics such as clarithromycin, the heart rhythm drug quinidine, and some antifungal medications including ketoconazole and itraconazole. If any of these strong inhibitors are taken, the Abilify dose will need to be cut in half.

Some drugs do the opposite: they speed up the enzymes that break down aripiprazole. Concentrations of aripiprazole in the blood go down quickly, and the drug loses its effectiveness. Abilify doses may need to be increased when combined with these drugs. 

Some other types of drug interactions may also cause problems. Other psychiatric medications, including selective serotonin reuptake inhibitors (fluoxetine, citalopram, duloxetine, paroxetine, sertraline, escitalopram, etc.) may add the serotonergic effects of Abilify, potentially causing serotonin syndrome. Abilify will also increase the effects of blood pressure medications, which may put patients at risk of low blood pressure. Abilify also increases the sedative effects of benzodiazepines such as lorazepam. In all cases, healthcare providers will monitor side effects more closely.

Is it safe to take Abilify during pregnancy?

Women who are pregnant or breastfeeding should be cautious about taking Abilify, especially during the third trimester. While there is little evidence that Abilify will cause birth defects, babies have been born with extrapyramidal symptoms (involuntary muscle movements) or withdrawal symptoms when Abilify is taken in the third trimester.

Related resources for Abilify dosages:

• Abilify, Epocrates

• Abilify MyCite prescribing information, U.S. National Library of Medicine

• Abilify (aripiprazole), U.S. National Library of Medicine

• Aripiprazole, StatPearls

• Aripiprazole (Abilify), National Alliance on Mental Illness

• Aripiprazole withdrawal: A case report, Innovations in Clinical Neuroscience 

• Augmentation treatment in major depressive disorder: Focus on aripiprazole, Neuropsychiatric Disease and Treatment