Aripiprazole
Abilify
Second-Generation Antipsychotic (Partial D2 Agonist)Generic availableTDM data
The mechanism of action of aripiprazole in schizophrenia is unclear. However, the efficacy of aripiprazole in the listed indications could be mediated through a combination of partial agonist activity at D 2 and 5-HT 1A receptors and antagonist activity at 5-HT 2A receptors.
Compare Aripiprazole →FDA-Approved Indications
- Schizophrenia (adults; adolescents 13+)
- Irritability associated with autistic disorder (6–17 years)
- Tourette's disorder (6–18 years)
Common Off-Label Uses
- Bipolar depression (adjunct)
- Tic disorders
- Agitation in dementia
- Treatment-resistant OCD (adjunct)
What Sets This Drug Apart
- D2/5-HT1A partial agonist (not a full antagonist like most antipsychotics); shared with brexpiprazole and cariprazine
- Prolactin-lowering rather than prolactin-elevating: label lists 'blood prolactin decreased' as frequent, 'blood prolactin increased' as rare
- Akathisia and activating side effects more prominent than sedation in adults
- Broadest FDA indication coverage among SGAs: 5 approved indications spanning psychosis, mania, depression adjunct, autism irritability, and Tourette's
- Very long half-life (~75 hours parent, ~94 hours active metabolite) — 14 days to steady state
- No appreciable muscarinic receptor affinity
Boxed Warning
WARNINGS: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS AND SUICIDAL THOUGHTS AND BEHAVIOURS WITH ANTIDEPRESSANT D