Aripiprazole is an atypical antipsychotic that blocks D2, H1, 5-HT2, and alpha-1 receptors. The drug also acts a partial agonist at 5-HT1 and D2 receptors. Instead of simply activating or blocking dopamine receptors, the medication modulates dopamine activity depending on the amount of dopamine present i.e. dopamine system stabilizer (DSS). Although technically considered a 3rd generation antipsychotic given its notable partial agonism at D2 receptors, aripiprazole is still mostly regarded as a 2nd generation antipsychotic with unique properties.
Since aripiprazole helps stabilize dopamine levels, the medication may help improve positive and negative symptoms of schizophrenia (refer to the Picmonic on "Schizophrenia Assessment"). The drug helps improve cognitive function. Compared with other antipsychotic medications, aripiprazole has a low risk of causing extrapyramidal symptoms or tardive dyskinesia.
Aripiprazole is indicated to help treat the manic symptoms of bipolar disorder (refer to the Picmonic on "Bipolar Disorder Assessment"). The medication may be used alone or in conjunction with lithium or valproate. Compared with 1st generation antipsychotics, the drug has a lower risk of causing sedation, orthostatic hypotension, and weight gain.
Aripiprazole is indicated to help treat symptoms of major depressive disorder. The medication is typically used as an adjunct to other drug therapy for treating depression. Warn the patient about the risk of weight gain while taking aripiprazole.
Aripiprazole may cause headaches that may go away as the body adjusts to the medication.
Aripiprazole may cause dizziness, lightheadedness, and vertigo. To prevent falls, instruct the patient to sit down if experiencing dizziness.
The patient taking Aripiprazole may experience nausea and vomiting. Since these symptoms may also indicate drug overdose, the patient should seek immediate healthcare treatment.
Aripiprazole may cause insomnia and prevent the patient from getting enough sleep. This may lead to frustration since the medication may also induce tiredness or sleepiness.
Patients taking aripiprazole may experience symptoms of anxiety. They may be easily agitated or demonstrate nervousness. The patient may show signs of restlessness and have difficulty focusing.
Since aripiprazole modulates dopamine receptors instead of simply activating or blocking them, the drug has a low risk of causing extrapyramidal symptoms (EPS). The incidence of EPS in patients taking aripiprazole is comparable with patients taking a placebo.
Although aripiprazole may cause weight gain, the significance is low compared with other antipsychotic medications. Weight gain may lead to the development of diabetes and dyslipidemia. Warn the patient about the risk of weight gain and provide education regarding healthy nutrition and exercise to help minimize weight gain.
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