Aripiprazole: A Guide to Dosing for Agitation and Aggression Associated with Psychiatric Disorders

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Aripiprazole, commonly known as Abilify, is an atypical antipsychotic medication primarily used to treat psychiatric disorders such as schizophrenia and bipolar disorder.

However, it is also an effective treatment for the agitation and aggression associated with these disorders, as well as substance intoxication or other organic causes.

In this article, we’ll talk about how much aripiprazole to take to treat agitation and aggression caused by mental illnesses.

Key takeaways

  • Aripiprazole is an atypical antipsychotic medication used primarily to treat schizophrenia and bipolar disorder, but can also be used to treat agitation and aggression associated with these disorders as well as substance intoxication or other organic causes.
  • Aripiprazole is available in various formulations, including oral tablets, oral solution, and -two extended-release (ER) intramuscular (IM) injections – aripiprazole monohydrate and aripiprazole lauroxil.
  • The manufacturer’s labeling recommends waiting at least 2 weeks before increasing the dose of aripiprazole due to its long half-life, but it may be appropriate to increase the dose after just 1 week depending on the patient’s response to treatment.
  • Aripiprazole may be used as an alternative agent to treat agitation and aggression associated with psychiatric disorders, but antipsychotics are only appropriate when psychosis is suspected to be the primary cause of agitation/aggression. Other agents may be used preferentially depending on the presentation of symptoms.
  • The initial dose of oral aripiprazole for the treatment of agitation and aggression associated with psychiatric disorders is typically between 10 to 15 mg, and the maximum daily dose is typically 30 mg/day. It is important to monitor patients closely for adverse effects and adjust the dosage accordingly.

Formulations

Aripiprazole is available in various formulations, including oral tablets, oral solution, and two extended-release (ER) intramuscular (IM) injections  aripiprazole monohydrate and aripiprazole lauroxil.

All doses are expressed as the equivalent amounts of aripiprazole (base).

Aripiprazole tablets are also available with an embedded device that tracks drug ingestion using a smartphone app called Abilify MyCite.

Titration

To ensure optimal treatment outcomes, it is essential to follow the manufacturer’s labeling when titrating aripiprazole.

The labeling recommends waiting at least 2 weeks before increasing the dose of aripiprazole due to its long half-life.

However, in some cases, it may be appropriate to increase the dose after just 1 week, depending on the patient’s response to treatment.

Agitation/aggression (acute, severe)

When agitation or aggression is associated with psychiatric disorders, aripiprazole may be used as an alternative agent to treat the symptoms.

It is important to note that antipsychotics are only appropriate when psychosis is suspected to be the primary cause of agitation/aggression.

In some cases, other agents may be used preferentially, such as benzodiazepines for alcohol withdrawal or stimulant intoxication.

Depending on the presentation of symptoms, aripiprazole may be combined with a benzodiazepine for optimal effect.

Oral dosing

The initial dose of oral aripiprazole for the treatment of agitation and aggression associated with psychiatric disorders is typically between 10 to 15 mg.

This dose may be repeated every 2 hours based on the patient’s response and tolerability. The maximum daily dose of aripiprazole is typically 30 mg/day.

Monitoring and adverse effects

As with all medications, it is essential to monitor patients closely for adverse effects and adjust the dosage accordingly.

Some common side effects of aripiprazole include nausea, vomiting, headache, and constipation.

More severe side effects may include tardive dyskinesia, neuroleptic malignant syndrome, and metabolic changes.

Conclusion

Aripiprazole is a valuable medication for treating agitation and aggression associated with psychiatric disorders.

When using aripiprazole, it is important to follow the manufacturer’s guidelines for dosing and titration.

As with all medications, it is essential to monitor patients closely for adverse effects and adjust the dosage accordingly.

With proper dosing and monitoring, aripiprazole can significantly improve the quality of life for individuals with psychiatric disorders.

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Morgan
Author: Morgan

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