Abilify (aripiprazole)

How does it work?

Abilify tablets, orodispersible tablets and oral solution all contain the active ingredient aripiprazole, which is a type of medicine known as an atypical antipsychotic. It is used to treat schizophrenia.

The way in which aripiprazole works is not fully understood, however, it does work in a slightly different way to other antipsychotic medicines.

Aripiprazole works by acting on various receptors in the brain, particularly dopamine receptors and serotonin (5HT) receptors. Dopamine and serotonin are natural compounds called neurotransmitters, and are involved in transmitting messages between brain cells. Psychotic illness is considered to be caused by disturbances in the activity of neurotransmitters (mainly dopamine) in the brain. Aripiprazole is thought to work mainly by stabilising the dopamine activity in the brain.

People with schizophrenia may experience 'positive symptoms' (such as hallucinations, delusions and hostility) and/or 'negative symptoms' (such as lack of emotion and social isolation).

The positive symptoms are thought to be due to overactivity of dopamine in certain areas of the brain. Aripiprazole blocks the dopamine receptors in these areas and so prevents the overactivity. This helps control the positive symptoms of the disease.

The negative symptoms, as well as cognitive symptoms such as memory loss and poor attention, are considered to be due to underactivity of dopamine in other areas of the brain. In these areas, aripiprazole stimulates the dopamine receptors. This mimics the activity of dopamine in these areas of the brain and so improves their activity. This helps improve the negative and cognitive symptoms of this illness.

Abilify orodispersible tablets and oral solution can be used as an alternative to the standard tablets for people who have difficulty swallowing. The orodispersible tablets are designed to dissolve on the tongue in the saliva without the need for a drink of water. These tablets are fragile and should be taken as soon as they are removed from the blister packet. Alternatively, these tablets can be dispersed in a glass of water.

What is it used for?

Schizophrenia.

Warning!

This medicine may reduce your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance.

If you feel sleepy or lightheaded while taking this medicine, these side effects are likely to be made worse by drinking alcohol.

Unless your doctor tells you otherwise, you should not suddenly stop taking this medicine, even if you feel better and think you don't need it any more. This is because the medicine controls the symptoms of the illness but doesn't actually cure it. This means that if you suddenly stop treatment your symptoms could come back.

Consult your doctor immediately if you experience abnormal movements, particularly of the face, lips, jaw and tongue, while taking this medicine. These symptoms may be indicative of a rare side effect known as tardive dyskinesia, and your doctor may ask you to stop taking this medicine, or decrease your dose.

Consult your doctor immediately if you experience the following symptoms while taking this medicine: high fever, sweating, muscle stiffness, faster breathing and drowsiness or sleepiness. These symptoms may be due to a rare side effect known as the neuroleptic malignant syndrome, and your treatment may need to be stopped.

Use with caution in

People over 65 years of age

Severely decreased liver function

Disease involving the heart and blood vessels (cardiovascular disease), eg history of heart attack, angina, heart failure, heart block or abnormal heart beats

Family history of a type of abnormal heart beat seen on a heart monitoring trace (ECG) as a 'prolonged QT interval'

Disease involving the blood vessels in the brain (cerebrovascular disease), eg history of stroke

Low blood pressure (hypotension), eg due to dehydration, blood loss, severe vomiting or diarrhoea, or treatment with diuretics or medicines for high blood pressure

High blood pressure

History of fits (seizures), eg epilepsy

Diabetes or family history of diabetes

Obesity

Difficulty swallowing (dysphagia).

Not to be used in

Breastfeeding.

This medicine has not been studied in children and adolescents under the age of 18 and it is not recommended for this age group.

This medicine should not be used to treat elderly people with psychosis associated with dementia, eg Alzheimer's disease, as it may increase the risk of stroke or death in this group of people.

Abilify tablets contain lactose and should not be taken by people with rare hereditary problems of galactose intolerance, the lapp lactase deficiency or glucose-galactose malabsorption.

Abilify oral solution contains fructose and sucrose and should not be taken by people with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency.

Abilify orodispersible tablets contain aspartame, which is a source of phenylalanine. This type of tablet should not be taken by people with an inherited disorder of protein metabolism called phenylketonuria.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

The safety of this medicine for use during pregnancy has not been established. It is not recommended for use in pregnancy unless considered essential by your doctor. Seek medical advice from your doctor if you get pregnant, think you could be pregnant, or want to plan a pregnancy while taking this medicine.

It is not known if this medicine passes into breast milk. The manufacturer states that mothers who need to take this medicine should not breastfeed. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Dizziness

Difficulty in sleeping (insomnia)

Anxiety, restlessness and agitation (akathisia)

Sleepiness (somnolence)

Shaking, usually of the hands (tremor)

Headache

Blurred vision

Weakness or loss of strength (asthenia)

Fatigue

Gut disturbances such as constipation, indigestion, nausea and vomiting

Increased heart rate (tachycardia)

A drop in blood pressure that occurs when moving from a lying or sitting position to sitting or standing, causing dizziness and lightheadedness (postural hypotension)

Abnormal movements of the hands, legs, face, neck and tongue, eg tremor, twitching, rigidity (extrapyramidal effects)

Increased blood sugar levels (hyperglycaemia)

Seizures

Increased salivation

Pain in the muscles

Prolonged erection (priapism)

Increase or decrease in body weight

Abnormal heart beats

Inflammation of the liver (hepatitis) or pancreas (pancreatitis)

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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