Experiences with
Aripiprazole

Aripiprazole is a medicine that helps with mental health conditions such as:

schizophrenia, where you may see, hear or feel things that are not there, believe things that are not true, feel unusually suspicious, or have muddled thoughts
the mania symptoms of bipolar disorder, where your mood changes from feeling highly excited (mania) to feeling very low (depression)

It's an antipsychotic medicine that works by affecting chemicals in your brain such as dopamine and serotonin. It does not cure your condition, but it can help with the symptoms.

Aripiprazole is only available on prescription.

It comes as tablets, including tablets that melt in your mouth (orodispersible tablets), and a liquid that you swallow. It can also be given as an injection.

Who can take aripiprazole

Most adults can take aripiprazole.

Most children and young people aged 15 years old and over can take aripiprazole for schizophrenia. Those aged 13 years old and over can take it for mania in bipolar disorder.

Who may not be able to take aripiprazole

Aripiprazole is not suitable for some people. To make sure it's safe for you, tell your doctor before starting to take it if you have:

ever had an allergic reaction to aripiprazole or any other medicine
a heart problem such as an irregular heartbeat (arrhythmia)
low blood pressure or high blood pressure
ever had problems controlling the movements of your tongue, mouth and face
ever had a rare condition called neuroleptic malignant syndrome (symptoms include a high temperature, muscle stiffness, sweating, anxiety and excess saliva)
epilepsy
diabetes or someone in your family has diabetes
had a blood clot – or someone in your family has had blood clots
had a stroke or are at high risk of having a stroke
Alzheimer's disease or another type of dementia
liver problems
ever had problems with gambling or disorders related to lack of impulse control

Dosage and strength

Standard aripiprazole tablets come in strengths of 5mg, 10mg, 15mg and 30mg.

The tablets that melt in your mouth (orodispersible tablets) come in strengths of 10mg, 15mg and 30mg.

The liquid contains 1mg per 1ml.

Your dose of aripiprazole depends on why you're taking it. Your doctor may change your dose depending on how well it works for you.

If you have problems with your liver, your doctor may ask you to take a lower dose and increase your dose very slowly.

Dose for schizophrenia

The usual starting dose for adults is 10mg or 15mg a day, taken as a single dose.

Most people feel better on daily doses of 15mg. Your doctor may increase your dose up to 30mg a day if you need it.

Children and young people aged 15 years old and over will usually start with a low dose of 2mg a day for 2 days. Your child's doctor will increase this to 5mg a day for 2 days and then 10mg a day, taken as a single dose.

Most children and young people feel better with daily doses of 10mg. Your child's doctor may increase their dose slowly up to 30mg a day if they need it.

Some people with schizophrenia need to have aripiprazole as an injection. Usually, you'll have been taking aripiprazole tablets or liquid before switching to the injection.

Dose for mania

The usual starting dose for adults is 15mg a day, taken as a single dose. Your doctor may increase your dose up to 30mg a day if you need it.

Children and young people aged 13 to 17 years old usually start with a low dose of 2mg a day for 2 days. Your child's doctor will increase this to 5mg a day for 2 days and then 10mg a day, taken as a single dose.

Most children and young people feel better with daily doses of 10mg. Your child's doctor may increase their dose slowly up to 30mg a day if they need it. They'll also tell you how long your child needs to take it for. This is usually up to 12 weeks.

How to take tablets and liquids

You can take aripiprazole tablets or liquid with or without food.

Try to take your dose at around the same time each day.

Standard tablets

Swallow your tablet with a drink of water.

Tablets that melt in your mouth (orodispersible)

Make sure your hands are dry. Only remove a tablet from the pack when you're ready to take it and put it on your tongue straight away.

The tablet will start dissolving within seconds. You can have a drink of water afterwards if you like.

Instead of putting the tablet on your tongue, you can put it in a small glass of water if you prefer. Drink the water as soon as the tablet has dissolved and make sure you finish it all.

Liquid

Your medicine will come with a syringe, dropper (pipette) or measuring cup to help you measure out the right dose. If you do not have one, ask a pharmacist for one.

Follow the instructions in the leaflet that comes with your medicine.

Injection

If you have aripiprazole as an injection, you'll usually have it once a month at your GP surgery or from your mental health team.

After you've had an injection, the medicine works for a few weeks. The dose will depend on how well it works for you.

Aripiprazole also comes as a short-acting injection, but this is usually only given in hospital if you need your symptoms to be treated quickly.

How long to take it for

You may need to take aripiprazole for a long time.

It's important to keep taking your medicine for as long as your doctor tells you. If you want to stop taking aripiprazole, talk to your doctor first.

Keep taking aripiprazole even if you feel better. Do not stop taking it without talking to your doctor.

If you miss a dose, take the missed dose as soon as you remember if it's within a few hours. If you miss a whole day's dose, skip the missed dose and take it the next day at the usual time.

Do not take 2 doses to make up for a forgotten dose.

If you miss 2 or more doses, contact your doctor for advice.

If you forget or cannot have your long-acting injection, talk to your doctor or nurse as soon as possible to rearrange the appointment.

If you often forget doses it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

Taking too much aripiprazole can cause serious side effects. You may:

feel sleepy or tired
have a fast heartbeat
feel sick, be sick or have diarrhoea
have muscle spasms
have unusual body movements

you've taken more than your prescribed dose of aripiprazole

Go to 111.nhs.uk or call 111

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the aripiprazole packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Do not stop taking aripiprazole unless your doctor tells you to. If you stop taking it your symptoms may come back.

If your doctor asks you to stop taking aripiprazole, your dose may be reduced slowly over a few days.

Talk to your doctor if you have any problems when you reduce your dose or stop taking it.

Common side effects

These common side effects of aripiprazole may happen in up to 1 in 10 people. There are things you can do to help cope with them:

This usually gets better over time. If you've been taking the medicine at night, you can switch to taking it in the morning.

Avoid having a big meal, smoking, or drinking alcohol, tea or coffee in the evening. Try not to watch television or use your mobile phone before going to bed. Instead, try to relax for an hour before bedtime.

If your sleep does not get better, talk to your doctor.

This usually gets better over time. If it does not improve after a few days, talk to your doctor.

Make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller.

Talk to your doctor if headaches last longer than a week or are severe.

Stick to simple meals and do not eat rich or spicy food. It might help to take your aripiprazole after you've had a meal or snack.

If you're being sick, try having small, frequent sips of water or squash to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee.

Do not take any other medicines to treat vomiting without speaking to a pharmacist or doctor.

If you take the combined contraceptive pill or progestogen-only pill and you're being sick, your contraception may not protect you from pregnancy. Check the pill packet for advice.

It may help if you avoid rich or spicy food while you're taking this medicine.

Get more fibre into your diet, such as fresh fruit, vegetables and cereals, and drink plenty of water. Try to exercise more regularly, for example, by going for a daily walk or run. If this does not help, talk to your pharmacist or doctor.

Do not drive, ride a bike or use tools or machinery if you feel sleepy. As your body gets used to aripiprazole, this tends to wear off over time. If you've been taking the medicine in the morning, you can switch to taking it in the evening.

If you're still feeling sleepy after a few weeks, speak to your doctor.

Speak to your doctor if you get this side effect.

Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.

Serious side effects

Call your doctor or call 111 now if you:

feel thirsty, need to pee a lot, feel tired and are losing weight – these could be signs of high blood sugar or diabetes
find it difficult to control your impulse or temptation to do something that could harm you or others, such as gambling too much, increased sex drive, uncontrollable shopping, binge eating, or a tendency to wander away
get swelling, pain and redness in your leg – this could be a sign of a blood clot
get problems with your movement such as feeling like you need to move all the time, difficulty moving or stiff muscles that make your movements jerky
get uncontrollable movements of your mouth, tongue and limbs
get twisting movements of your body or limbs, such as your neck being twisted to the side or your feet turning inwards – this could be a sign of a condition called dystonia
have a fast heartbeat

you have chest pain
you have difficulty breathing
you have had a seizure or fit
you have a painful erection that lasts more than 2 hours – this may happen even when you're not having sex
you have a high temperature, muscle stiffness, sweating, anxiety or excess saliva – these may be signs of a disorder called neuroleptic malignant syndrome
you have thoughts about harming yourself or ending your life or harming others

Find your nearest A&E

Meds - serious side effects A&E safety messaging

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to aripiprazole.

Meds New IA (H4) - serious allergic reaction

These are not all the side effects of aripiprazole. For a full list see the leaflet inside your medicines packet.

Aripiprazole and pregnancy

There's no good evidence that taking aripiprazole in early pregnancy will affect your baby.

Taking it in the weeks before birth may sometimes cause withdrawal symptoms in the newborn baby. However, these symptoms do not last long. Your baby will be checked after they're born and given extra care if needed.

It's important that mental health conditions are well treated since these can affect both your and your baby's wellbeing. Good treatment is important because symptoms of a mental health condition sometimes get worse during pregnancy or after your baby is born.

Speak to your doctor if you become pregnant. They'll help you decide on the best treatment for you and your baby.

Aripiprazole and breastfeeding

If your doctor or health visitor says your baby is healthy, you can take aripiprazole while breastfeeding.

It's important to keep taking aripiprazole to keep you well. Breastfeeding will also benefit both you and your baby.

There's not much information about taking aripiprazole while breastfeeding, but the information shows that it passes into breast milk in small amounts. It has not been known to cause any side effects in breastfed babies. However, it may reduce the amount of milk you produce.

Your doctor will advise you whether other medicines might be more suitable.

If you notice that your baby is not feeding as well as usual, seems unusually sleepy, seems irritable, is having sudden or jerky movements, or if you have any other concerns about your baby, talk to your health visitor, midwife, pharmacist or doctor as soon as possible.

Aripiprazole and fertility

There's no evidence that taking aripiprazole will reduce fertility in either men or women.

Meds New IA (H2) - Pregnancy non-urgent care card

Cautions with other medicines

There are many medicines that can affect the way aripiprazole works, or that increase the risk of side effects.

It's very important to check a medicine is safe to take with aripiprazole before you start taking it.

Tell your doctor or pharmacist if you're taking any other medicines, including:

medicines for problems with your heart rhythm, such as quinidine, amiodarone or flecainide
medicines to lower your blood pressure
medicines that make you feel sleepy, including benzodiazepines such as diazepam, opioid painkillers such as morphine, pethidine or tramadol, or drowsy antihistamines such as chlorphenamine – aripiprazole can increase the effects of these medicines and make you feel more sleepy
ketoconazole or itraconazole, medicines for fungal infections
medicines for depression such as fluoxetine, paroxetine or venlafaxine
some medicines to treat HIV infection such as efavirenz, nevirapine, indinavir or ritonavir
rifabutin or rifampicin, medicines for tuberculosis (TB)
carbamazepine, phenytoin or phenobarbital, medicines for epilepsy
triptans such as sumatriptan or zolmitriptan, for migraines

Mixing aripiprazole with herbal remedies and supplements

There might be a problem taking some herbal remedies and supplements with aripiprazole, especially ones that make you feel sleepy or dizzy. Ask a pharmacist for advice.

Do not take St John's wort, a herbal remedy for depression. It may stop aripiprazole working as well as it should.

There's not enough information to say that other complementary medicines, herbal remedies and supplements are safe to take with aripiprazole. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Meds New IA (H2) - Cautions with other medicines alert