Aripiprazole ODT

Generic name:

Aripiprazole

Drug class:

Atypical antipsychotic (second-generation antipsychotic)

Dosage form:

• Orally disintegrating tablets (ODT): 2 mg, 5 mg, 10 mg, 15 mg, 20 mg, 30 mg

Route of administration:

Oral (sublingual/orally disintegrating)

Dose:

• Schizophrenia adults: 10–15 mg once daily (range 2–30 mg)
• Bipolar I mania: 15 mg once daily (range 2–30 mg)
• Major depressive disorder (adjunct): 2–5 mg once daily
• Irritability in autism (6–17 years): 5–15 mg once daily
• Tourette’s disorder (6–18 years): 10 mg once daily (range 2–20 mg)
• Elderly with psychosis: start low, titrate cautiously (max 15 mg)
• Pediatric use: vary by indication; often start at 2–5 mg

Mechanism of action:

Partial agonist at dopamine D2 and serotonin 5-HT1A receptors; antagonist at serotonin 5-HT2A receptors; modulates dopaminergic and serotonergic neurotransmission.

Drug usage cases:

• Schizophrenia (adults and adolescents)
• Bipolar I disorder—acute manic and mixed episodes
• Major depressive disorder (adjunctive therapy)
• Irritability associated with autism spectrum disorder
• Tourette’s disorder
• Off-label: OCD, PTSD, borderline personality disorder, augmentation in anxiety disorders

Drug contraindications:

• Hypersensitivity to aripiprazole or any component of the formulation
• Use in elderly patients with dementia-related psychosis

Side effects:

• Akathisia, restlessness
• Parkinsonism (tremor, bradykinesia)
• Extrapyramidal symptoms
• Headache
• Insomnia, sedation
• Anxiety
• Weight gain, metabolic changes (hyperglycemia, dyslipidemia)
• Orthostatic hypotension, dizziness
• Constipation, nausea, vomiting
• Dysphagia
• Fatigue
• Dry mouth
• Prolactin elevation (less than typical antipsychotics)
• Seizures
• Tardive dyskinesia (potentially irreversible)
• Neuroleptic malignant syndrome
• QT interval prolongation

Warnings:

• Increased mortality in elderly patients with dementia-related psychosis
• Risk of suicidal thoughts and behaviors in children, adolescents, and young adults
• Metabolic monitoring: weight, glucose, lipids
• Tardive dyskinesia—discontinue if signs appear
• Neuroleptic malignant syndrome—discontinue and treat supportively
• Orthostatic hypotension—risk of syncope
• Seizure risk—use caution in patients with a history of seizures
• Cerebrovascular adverse events (stroke) in elderly with dementia
• Impulse control disorders (gambling, sexual, binge eating, shopping)

Use during pregnancy or breastfeeding:

Pregnancy: Category C. Animal studies show adverse effects; human data are limited. Use only if benefit justifies potential risk. Newborns exposed late in pregnancy may develop extrapyramidal and/or withdrawal symptoms.

Breastfeeding: Aripiprazole is excreted in breast milk. Monitor infant for sedation, irritability. Consider risks of untreated maternal condition vs. potential infant exposure.