13 Abilify Side Effects You Should Know About

Abilify (aripiprazole) is an atypical antipsychotic medication that comes as a tablet, orally disintegrating tablet, and oral liquid. It also comes as a long-acting injection. Abilify treats several different conditions, including schizophrenia, bipolar disorder, and depression. Children may take Abilify to treat autism-related irritability and Tourette syndrome.

Antipsychotic medications are often known for causing a lot of side effects. And Abilify is no exception. But certain side effects, such as weight gain and sexual side effects, aren’t as common with Abilify. Even so, it’s good to know what you should expect from treatment.

Abilify side effects at a glance

Here is a list of both common and rare side effects you may experience while taking Abilify.

Common Abilify side effects:

• Nausea and vomiting

• Constipation

• Headache

• Dizziness

• Restlessness

• Anxiety

• Insomnia

• Fatigue

• Weight gain

• Increased or decreased appetite (in children)

• Blurry vision

• Drooling or excess saliva

Rare but serious Abilify side effects:

• Compulsive behaviors

• Neuroleptic malignant syndrome

• Tardive dyskinesia

• Blood pressure changes

• Low blood cell counts

• Seizures

Abilify also has two boxed warnings — the FDA’s most serious medication warning. They include:

• Increased risk of stroke and death in older adults with dementia-related psychosis

• Increased risk of suicidal thoughts in adults and children under age 25

Let’s take a closer look at 13 Abilify side effects and what you can do about them.

1. Headache

Headache is one of the most common Abilify side effects reported during clinical trials. They usually resolve on their own, but staying hydrated and getting enough sleep can often help.

If headaches become bothersome or get worse, talk to your prescriber. They may recommend an over-the-counter pain reliever, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), to help. In some cases, they may try lowering your Abilify dose or switching you to a different medication.

2. Nausea and vomiting

Nausea is also a common Abilify side effect. Vomiting can also happen, but it isn’t as common as nausea.

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Nausea may improve over time as your body gets used to Abilify. You can take it with or without food. But if you’re feeling nauseated after taking your dose, taking it with food may help. If nausea worsens or doesn’t improve, reach out to your prescriber for guidance.

3. Constipation

Constipation is a known side effect of many antipsychotics, including Abilify. Physical inactivity, not drinking enough water, and a low-fiber diet can make constipation from antipsychotics worse.

Talk to your prescriber about lifestyle changes you can make to help get things moving again. This may include eating high-fiber foods, keeping hydrated, and exercising regularly. Let them know if your constipation becomes bothersome or gets worse during treatment.

4. Weight gain

Weight gain can happen with antipsychotics.You may start to notice weight changes in the first few weeks after starting Abilify. But Abilify tends to cause less weight gain than other options. The amount of weight gain can vary. And it seems to happen more often in children taking Abilify than in adults.

Talk to your prescriber if you’re concerned about weight gain while taking Abilify. They can help you find the best way to manage your weight, including lifestyle changes. If needed, they may add another medication to help lessen weight gain. Medications such as metformin and topiramate (Topamax) are sometimes used off-label for this purpose.

5. Sleeping problems

Insomnia is also a common Abilify side effect. This may include trouble falling asleep or staying asleep. On the flip side, you may also feel sleepy or drowsy when starting Abilify. Drowsiness tends to be more common in children, and insomnia seems to be more common in adults.

You can take Abilify at any time of day. But if you’re having problems sleeping, talk to your prescriber about taking it in the morning. And if it’s making you drowsy, ask them about taking it in the evening.

If you’re experiencing insomnia, try these sleep hygiene tips or talk to your prescriber to see if melatonin is right for you. Let your prescriber know if you’re experiencing changes in your sleep patterns while taking Abilify. This may also be a sign of worsening mental health symptoms that require further treatment.

6. Blurry vision

Blurry vision is a common Abilify side effect. It’s not clear why this happens, but in most cases, it isn’t anything to be worried about. Still, it’s a good idea to let your prescriber know if any vision changes occur while taking Abilify. This is because in rare cases, Abilify may cause more serious eye problems that affect your vision. Your prescriber can help determine what’s going on and may refer you to an eye specialist if needed. 

In most cases, blurry vision will resolve on its own. But you may also need to stop taking Abilify if vision changes become a problem. They typically go away on their own once the medication is out of your system.

7. Excess saliva and drooling

Like weight gain, excess saliva or drooling are side effects of several antipsychotic medications. It’s less common with Abilify in adults, but children taking Abilify are more likely to experience this side effect.

If drooling becomes excessive or is bothersome, talk to your prescriber. They may want to try a lower Abilify dosage, or they may prescribe another medication to help dry up the extra saliva. If these methods aren’t successful, they may switch to a different antipsychotic medication.

8. Anxiety

Anxiety is another possible Abilify side effect. You may feel agitated, overexcited, or more anxious than usual.

Limiting caffeine, practicing mindfulness, and walking regularly may help lessen anxiety symptoms. And they may improve over time as your body gets used to taking Abilify. But if they’re causing distress, talk to your prescriber. They may try a lower Abilify dosage to see if that helps.

Keep in mind that anxiety may also be a symptom of the health condition you’re taking Abilify for. Your prescriber can help determine if that’s the case and how best to manage it.

9. Blood pressure changes

Blood pressure changes aren’t common with Abilify, but they’re still possible. For example, sitting or standing up too quickly may cause you to feel lightheaded, dizzy, or cause you to pass out. This may be more likely if you have heart disease or other risk factors.

It’s important to be cautious when changing positions. The blood pressure changes from getting up too quickly could cause you to fall. This may result in fractures (bone breaks).

Because of how it works, Abilify may increase the effects of blood pressure medications if they’re taken together. Your prescriber may want to monitor your blood pressure to ensure it’s not getting too low. Let them know if you’re experiencing frequent symptoms of low blood pressure, such as feeling light-headed or dizzy.

10. Movement problems

Antipsychotic medications can cause movement problems known as extrapyramidal symptoms (EPS). Abilify is less likely to cause them than some other antipsychotics, but they’re still possible. Akathisia is the most common EPS from Abilify. This side effect can make you feel restless or unable to sit still. And it can be easy to mistake it for anxiety or agitation. But while akathisia can be frustrating, it’s usually not dangerous. Let your prescriber know if you notice signs of akathisia. They may decide to lower your dose or switch you to a different medication.

A serious, but rare EPS that can occur is tardive dyskinesia. Symptoms include twitching of the face and mouth and uncontrolled movement of the legs, arms, and torso. More rarely, it may involve the muscles used for breathing, causing you to breathe too fast or have trouble breathing.

In some cases, tardive dyskinesia symptoms may be permanent. It’s best to take the lowest effective Abilify dose to manage this risk. Lowering your caffeine intake and improving your sleep hygiene may also reduce tardive dyskinesia symptoms.

If these symptoms develop, you should let your prescriber know. They’ll likely have you stop taking the medication. But don’t try to do this on your own. Stopping Abilify abruptly can lead to withdrawal as well as a return of your condition’s symptoms.

11. Compulsive behaviors

While rare, some people may develop compulsive behaviors or uncontrolled urges while taking Abilify. This may involve gambling and binge eating, as well as shopping and sex.

If you notice a change in your behavior, let your prescriber know. These urges tend to go away after lowering the dose or stopping Abilify. Remember: Don’t try to stop taking Abilify on your own without consulting your prescriber.

12. Neuroleptic malignant syndrome

Neuroleptic malignant syndrome (NMS) is a rare, life-threatening side effect of Abilify. Signs of NMS include high fever, stiff muscles, and confusion. You may also experience uncontrolled changes in your heart rate, blood pressure, or breathing.

Get immediate medical attention if these symptoms develop while taking Abilify. Leaving NMS untreated can result in death.

13. Suicidal thoughts

Abilify has a boxed warning (the FDA’s strictest warning for medications) about the risk of suicidal thoughts and behaviors. This risk appears to be highest in people under 25 years old. But everyone taking Abilify should be aware that suicidal thoughts and behaviors may happen, especially when starting treatment and after any dosage changes.

Let your prescriber know if you notice changes in your mood and behavior, or that your symptoms are getting worse.

If you or someone you know is having thoughts of suicide, you’re not alone, and help is available. Call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.

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Written by:

Zuri C. Hawkins-Jarrett, PharmD, MPH, BCPS

Zuri Hawkins-Jarrett graduated with her doctorate in pharmacy from The University of Georgia College of Pharmacy. She completed her residency training with Piedmont Columbus Regional in ambulatory care.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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