Aripiprazole Review: The Best Drug for Schizophrenia?

Aripiprazole Review: The Best Drug for Schizophrenia?


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Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regard to prescription medication.

Aripiprazole is an FDA-approved drug that's primarily used to treat schizophrenia, but is also approved to treat bipolar disorder, acute mania and depression. 

But is the drug proven to be effective for all of these conditions? Is it more effective for one than the others? Does it cause concerning side effects? Is apiprazole as effective as its brand-name counterpart Abilify? And how do real users rate its effects?

In this article we'll answer all of these questions and more as we review medical studies on aripiprazole to determine its effectiveness, document its side effects, explain whether the drug causes weight gain and share real, unsponsored user reviews of aripiprazole.

Does Aripiprazole Work?

Aripiprazole has been studied for the treatment of a number of mental health conditions, including schizophrenia, mania, bipolar disorder and depression.

A 2010 medical study examined the efficacy of aripiprazole for treating schizophrenia. Researchers examined 11 clinical trials on the topic.

What the researchers found was that aripiprazole is effective as a standalone therapy for schizophrenia in both short-term and long-term trials. Over 70% of patients rated the drug as more effective than the prior medication they were taking for schizophrenia.

Aripiprazole was even found to successfully manage treatment-resistant schizophrenia, which is defined as schizophrenia that did not respond to other drugs.

Another medical review, published in the Cochrane Database of Systematic Reviews journal, analyzed whether aripiprazole was effective for manic patients.

Aripiprazole was documented to be efficacious for reducing mania symptoms short-term (3 and 4 weeks from the start of the trial) but not long-term (6 weeks from the start of the trial). The drug was equally effective to two other commonly-prescribed mania medications; lithium and haloperidol.

A meta-study on aripiprazole for bipolar disorder analyzed data from 20 clinical trials on the topic.

The study authors found that aripiprazole could successfully treat some characteristics of BPD (acute mania, psychosis) but not others (depressive symptoms). It was concluded to be effective overall because it improved patients’ quality of life when compared to placebo.

A 2009 clinical trial examined the efficacy of aripiprazole as an adjunctive therapy (taken in combination with other medications) for depression. After 14 weeks, 36.8% of patients using aripiprazole experienced a partial or full reduction in their depression symptoms.

Overall aripiprazole has shown effectiveness for all of the conditions it's approved to treat. In our opinion, the research backing for aripiprazole as a treatment for schizophrenia is more impressive than the data on the drug for other conditions.

Aripiprazole Side Effects

Aripiprazole does cause side effects in some patients.

According to a medical review published in the Expert Opinion on Pharmacotherapy journal, the most common side effects of aripiprazole are restlessness, drowsiness and nausea. 

The FDA also published a warning letter in 2016 highlighting how the drug causes impulse-control problems in some patients. The FDA claimed that the notice on the drug’s label about gambling risk wasn’t comprehensive enough, and that compulsive eating, shopping and sexual habits were also a risk.

Aripiprazole’s FDA label has a “black box” warning which explains how the drug may increase suicidality in pediatric, adolescent and young adult patients. The warning also indicates that the drug may increase the risk of death in elderly patients with dementia-related psychosis.

We would recommend that patients in the at-risk groups such as young adult patients, patients with a personal or family history of gambling addiction, or elderly patients with dementia-related psychosis speak with their doctor about alternative medications that may not have such severe side effects.

Real, Unsponsored User Review of Aripiprazole

A YouTube creator called "lifesatwitchemma" published a review of her experience on aripiprazole including the benefits of the drug and side effects she experienced. The video has "Abilify" in the title but that is the brand-name version of the drug and these two terms refer to the same active drug ingredient:

 

Is the Brand Name Version More Effective?

The brand name version of aripiprazole is called Abilify. Patients are often curious about whether the branded version is more effective than the generic version.

A 2019 medical review analyzed data from over 1 million patients and found that generic and brand-name drugs were equally effective. This suggests that aripiprazole should be as effective as Abilify.

We would recommend that patients speak with their doctor about generic aripiprazole instead of Abilify. According to SingleCare, the average retail price of Abilify is over $1,000 at the time of updating this article, while aripiprazole can be purchased for $6 on Cost Plus Drugs (Mark Cuban's venture).

Does Aripiprazole Cause Weight Gain?

Aripiprazole does appear to cause weight gain based on clinical studies.

medical review published in the Journal of Psychopharmacology examined data from over 25,000 patients that had taken aripiprazole at least once. Patients taking aripiprazole as a standalone treatment gained an average of 3.4% body weight over the course of 180 days. This equates to a potential annualized weight gain of 6.8 pounds for a 200 pound adult.

Another meta-study compared the risk of weight gain from aripiprazole use with the risk of weight gain from other antipsychotic medications. The study authors found that aripiprazole was associated with moderate weight gain in clinical trials, but that the drug caused less weight gain than other drugs in the same class.

While aripiprazole does appear to cause modest weight gain, it may have a more favorable effect on weight than other prescription antipsychotics. This class of drugs tends to be associated with weight gain.

Given this information, it may be worthwhile for overweight and obese patients to speak with their doctor about medication options that are not associated with weight gain in clinical studies.

Aripiprazole Dosage

StatPearls, which is a comprehensive medical database, documents that the effective daily dosing range for oral formulations of aripiprazole is 5 milligrams (mg) to 30 mg. The drug comes in capsules of 2 mg, 5 mg, 10 mg, 15 mg, 20 mg and 30 mg.

Intramuscular aripiprazole dosage ranges from 441 mg to 1,064 mg, and is administered every 4 to 6 weeks. 

The dose used for treating schizophrenia and BPD tends to start at 10 or 15 mg and work up to 30 mg, while a lower dose of 2-5 mg is often prescribed for aripiprazole as an adjunctive treatment for depression.

Given such a wide dosing range, it's important that patients speak clearly with their doctor about the appropriate dosing of this medication. Doctors will often prescribe a new medication at the lower end of the dosing range to minimize the risk of side effects or bad reactions. If the patient fails to achieve benefits from the drug, their dose can be slowly increased.

Should I Take Aripiprazole in the Morning?

While only a doctor can recommend medication timing to an individual patient, there is some interesting research on the optimal timing of daily aripiprazole use.

A medical review published in the well-respected Frontiers in Psychiatry journal examined whether the timing of aripiprazole administration could affect metabolic risk. The researchers compared data on patients who took the drug in the morning and those who took the drug in the evening.

Patients taking aripiprazole in the evening had unfavorable effects on their cholesterol levels compared with those taking the drug in the morning. It’s not exactly clear why this occurred, but the study authors proposed that taking aripiprazole at night may increase overnight insulin release, which has negative downstream effects on cholesterol.

We would recommend that patients speak with their doctor about taking aripiprazole in the morning.

Does Aripiprazole Have Negative Interactions?

Like most prescription drugs, aripiprazole interacts with other medications and ingestible substances. A doctor should be aware of all of these interactions and check them against the patient's existing medication(s), but it's useful for patients to be aware of this information as well.

Aripiprazole negatively interacts with a number of medications, including antihypertension drugs (blood-pressure-lowering drugs), benzodiazepines (benzos), fluoxetine and many more. Patients should refer to aripiprazole's FDA label for a full list of these interactions.

One interesting note from the drug's label is that aripiprazole does not interact with lithium, which is a mineral that's frequently used to treat schizophrenia. This means that patients may be able to take both drugs concurrently with the approval of a doctor.

Our Mental Wellness Recommendation

We recommend a platform called Brightside to patients on a mental health journey. It's an online therapy and medication platform that connects patients with licensed therapists and doctors from the comfort of their home.

medical review published in the Clinical Psychology & Psychotherapy journal found that online therapy was equally effective to in-person therapy for treating depression, anxiety and PTSD. Therapy may be a good first option for patients who want to avoid the side effects of medication.

Brightside also can connect patients with licensed psychiatrists that can prescribe medication. Some patients choose only therapy, some choose only medication, and some choose both. The brand reports that 86% of members feel significantly better within 12 weeks of treatment.

Patients with and without health insurance can use Brightside. For many patients with health insurance, treatment is entirely covered by insurance.

The cost for medication without health insurance is capped at $95/month and the cost for therapy without health insurance is capped at $299/month.

Interested patients can check out Brightside at this link to the brand's website.

Aripiprazole User Reviews

Aripiprazole has been reviewed over 1,000 times on Drugs.com, which is a website where users of prescription medications can submit personal reviews of their experience on the drug.

Aripiprazole has a 5.8/10 average rating for treating schizophrenia, a 5.7/10 average rating for treating BPD and a 6.4/10 rating for treating depression.

The top positive review of aripiprazole for schizophrenia is written by a user named “justin” who claims the drug eliminated the intrusive thoughts they were experiencing:

“I've been on [aripiprazole] for about five days. And I noticed a big change. I'm not having any intrusive/destruction thoughts. I'm not hearing voices. Even my dreams have gotten better. So, I WOULD DEF RECOMMEND!”

The top negative review of aripiprazole for schizophrenia comes from a user named “Rose” who claims the medication caused an unpleasant mood:

“[Aripiprazole] wasted a year of my life. I had to abuse stimulants (which made my symptoms worse) to function. My hallucinations were semi controlled but I still heavily struggled with delusions. I thought it was the best I could get but no. After trying many more I found an antipsychotic that doesn't make me a robot.

Stay up-to-date on our research reviews

Conclusion

Aripiprazole is proven to be effective for treating schizophrenia, BPD, mania and depression. The clinical backing for the drug's treatment of schizophrenia is the most impressive in our opinion.

The drug does confer the risk of some significant side effects, such as suicidality, gambling and weight gain. Patients in at-risk groups like elderly patients with dementia-related psychosis and young adult patients should speak with their doctor about these risks, and about alternative medications which may not confer these risks, before taking aripiprazole.

Aripiprazole seems to be a better option than its branded alternative Abilify, because it should be equally effective but can be much cheaper, especially for patients without health insurance.




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