Atypical Antipsychotic (Partial D2 Agonist) Pregnancy: Should not be used in pregnancy unless the expected benefit clearly justifies the potential risk to the foetus. Neonates exposed in the third trimester are at risk of extrapyramidal and/or withdrawal symptoms — monitor carefully. Aripiprazole/metabolites are excreted in human milk; decide whether to discontinue breast-feeding or therapy.

Aripiprazole

Brand names: Abilify

Aripiprazole is an atypical antipsychotic used in schizophrenia and bipolar disorder; it is often chosen for its relatively favourable metabolic and sedation profile.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Schizophrenia: 10-15 mg/day (starting and maintenance); Manic episodes in Bipolar I Disorder: 15 mg/day starting dose

Route: oral

Frequency: once daily, without regard to meals

Max: 30 mg/day

Schizophrenia: recommended starting dose 10 mg/day or 15 mg/day with a maintenance dose of 15 mg/day; effective range 10-30 mg/day, though enhanced efficacy above 15 mg/day not demonstrated. Manic episodes in Bipolar I Disorder: starting dose 15 mg/day as monotherapy or combination therapy; some patients may benefit from a higher dose. Recurrence prevention of manic episodes: continue at the same dose. Maximum daily dose must not exceed 30 mg. Reduce dose with concomitant strong CYP3A4 or CYP2D6 inhibitors; increase dose with concomitant strong CYP3A4 inducers. Orodispersible tablets or oral solution may be used for patients who have difficulty swallowing tablets. A lower starting dose should be considered in the elderly when clinical factors warrant (efficacy/safety not established in patients ≥65 years). The SPC read covers oral tablets only; no depot/long-acting injectable posology in this source.

Dose adjustments

Renal

No dosage adjustment required in patients with renal impairment.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Initial Dose Recommended Dose Maximum Dose Schizophrenia – adults (2.1) 10 to 15 mg/day 10 to 15 mg/day 30 mg/day Schizophrenia – adolescents (2.1) 2 mg/day 10 mg/day 30 mg/day Irritability associated with autistic disorder – pediatric patients (2.4) 2 mg/day 5 to 10 mg/day 15 mg/day Tourette’s disorder – (2.5) Patients <50 kg 2 mg/day 5 mg/day 10 mg/day Patients ≥50 kg 2 mg/day 10 mg/day 20 mg/day •Oral formulations: Administer once daily without regard to meals (2) •Known CYP2D6 poor metabolizers: Half of the usual dose (2.7) 2.1 Schizophrenia Adults The recommended starting and target dose for aripiprazole is 10 or 15 mg/day administered on a once-a-day schedule without regard to meals. …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2026-03-05. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Contraindications

Hypersensitivity to the active substance or to any of the excipients

Side effects

Akathisia
Nausea
Insomnia
Extrapyramidal disorder / tremor
Headache
Somnolence / sedation / dizziness

Interactions

Strong CYP3A4 inhibitors (e.g. itraconazole, clarithromycin) or strong CYP2D6 inhibitors (e.g. quinidine, fluoxetine, paroxetine): reduce aripiprazole dose
Strong CYP3A4 inducers (e.g. carbamazepine, rifampicin): increase aripiprazole dose; reduce back to recommended dose when inducer withdrawn
No dosage adjustment required for smokers (metabolic pathway)

Clinical monograph

How it works

It is a partial agonist at dopamine D2 and serotonin 5-HT1A receptors and an antagonist at 5-HT2A, which underlies its distinctive profile.

Prescribing in practice

It tends to cause less sedation, weight gain and prolactin elevation than several other antipsychotics, but akathisia (restlessness) is common.
Impulse-control disorders (e.g. gambling, hypersexuality) are recognised — counsel and ask about them.
The antipsychotic stroke and mortality warning applies in older people with dementia.

Monitoring

Monitor weight, glucose and lipids and blood pressure; ask about akathisia and impulse-control behaviours.

Counselling the patient

Restlessness can occur — tell your clinician if so.
Report any new urges to gamble or other compulsive behaviour.
Do not stop it suddenly.

Evidence & guidelines

Used in schizophrenia and bipolar disorder (NICE NG178/CG185), with a relatively favourable metabolic profile but a risk of akathisia and impulse-control disorders.

Reference: NICE NG117 Psychosis and Schizophrenia; BAP Antipsychotic Guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways