Key takeaways
Abilify (aripiprazole) is an atypical antipsychotic. It’s approved for mental health conditions, including schizophrenia and bipolar 1 disorder.
How Abilify works depends on what you’re treating. But Abilify’s mechanism of action is to balance levels of two brain chemicals: dopamine and serotonin.
Abilify may take a couple of weeks to start treating your symptoms. But it can take longer, even a few months, to have full improvement in symptoms. Talk to your prescriber if you aren’t experiencing improvements. They may want to increase your dosage.
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The FDA approved Abilify (aripiprazole) in 2002. At the time, it was a novel antipsychotic medication that treated schizophrenia. Today it’s also approved for bipolar 1 disorder and hard-to-treat depression. Additionally, it can treat Tourette syndrome and irritability from autism in children. It’s also prescribed off-label for other conditions, such as obsessive-compulsive disorder.
If you take Abilify, you may ask, “How does Abilify work?” Our pharmacists explain Abilify’s mechanism of action. Plus, learn about other features of this medication.
What’s Abilify?
Abilify belongs to a group of medications called atypical antipsychotics. These are medications that target receptors (binding sites) in the brain.
Abilify comes in many forms, including oral tablets (such as Abilify Mycite) and liquid. It also comes as short-acting and long-acting injections (Abilify Maintena, Abilify Asimtufii, Aristada). The injectable forms need to be given in a medical setting.
Most of the oral forms are available as lower-cost generics. But Abilify Mycite, which has a sensor inside it, is not. The injections aren’t available as generics.
Not all Abilify products are interchangeable. They may have different FDA-approved uses and dosage instructions.
Abilify side effects: Abilify has several possible side effects. Knowing what to watch for and how to manage them can help minimize your risk.
Abilify drug interactions: If you take other medications and supplements with Abilify, make sure your prescriber and pharmacist have a list of what you take. They can help you check for drug interactions before you start Abilify.
Abilify and alcohol: We don’t know if any amount of alcohol is safe to drink with Abilify. That’s why it’s best to avoid it.
How does Abilify work on the brain?
Abilify mainly works by changing the balance of two important neurotransmitters (brain chemicals). These chemicals are:
Dopamine. This is part of the body’s “reward system.” It plays an important role in several other bodily functions. Abilify binds (attaches) to several types of dopamine receptors in your brain. It can block and boost dopamine’s effects, depending on how much dopamine is present.
Serotonin. This is called the happy hormone because it helps regulate your mood. It also helps with other body functions. Abilify activates a serotonin receptor called 5-HT1A, which increases serotonin’s effect. But Abilify also blocks serotonin’s effects at a different serotonin receptor (5-HT2A receptor).
Abilify balances brain chemicals, but research on how it has its effect is ongoing. For example, genetics may affect how Abilify works. Below, we’ll explore the main ways Abilify may work for each of its FDA-approved conditions.
Schizophrenia: Too much dopamine in parts of the brain may be partly responsible for psychosis symptoms. These include hallucinations and delusions. Researchers say that Abilify treats schizophrenia by keeping dopamine levels stable. Balancing serotonin levels may also help.
Treatment-resistant depression: If depression doesn’t respond to medication, Abilify is added to an antidepressant. Abilify likely improves mood by balancing brain levels of serotonin. Abilify’s effects on dopamine may benefit some people with depression. Other brain chemicals can improve when Abilify is combined with selective serotonin reuptake inhibitors.
Bipolar 1 disorder: Depressive symptoms of bipolar 1 disorder may be improved by Abilify. This is because the medication balances serotonin levels. Stable dopamine levels may also improve mania (an elevated or extremely irritable mood).
Tourette syndrome (TS): Researchers say a dopamine imbalance contributes to tics in TS. Abilify may help TS by stabilizing dopamine levels.
Irritability from autism spectrum disorder: Some research links irritability to imbalances in brain chemicals. For example, your brain may produce too much dopamine and too little serotonin. Abilify can help balance these chemicals.
Does Abilify start working right away?
Not usually. When Abilify starts working depends on which dosage form you’re using.
If you’re taking Abilify by mouth, each dose gets absorbed in 3 to 5 hours. But it may take 2 weeks or more for you to feel more significant effects. This is because it takes this long for Abilify to build up in your body to a level that’s effective.
Long-acting injectable Abilify forms may take a few weeks to have their effect. That’s why you’ll typically take Abilify in oral form too for the first couple weeks of treatment. The short-acting injectable form of Abilify is used in hospitals to treat agitation. It is absorbed quickly and starts working within 2 hours.
If you’re taking Abilify for a mental health condition, you’re looking for a change in your brain chemistry. This can take time. So experiencing the full benefit of Abilify takes several weeks to months.
How do you know if Abilify is working?
How to tell if Abilify is working depends on what you’re treating. But it won’t start working right away. Additionally, it may take some time to find the right dose.
Still, you’ll want to look for an improvement in symptoms to know if Abilify is working. For example, in schizophrenia and bipolar 1 disorder, you may feel less agitated within a few days. Hallucinations may also go away quickly. But other symptoms may take several weeks to improve. And in treatment-resistant depression, look for improvements in your mood. If you don’t experience improvement within a couple of weeks, you may need a dose increase.
Taking your doses exactly as prescribed and making note of your daily symptoms will help you figure out if Abilify is working for you. If you’re missing doses of oral Abilify, ask your healthcare professional about switching to a long-acting injectable option.
How is Abilify different from other antipsychotics?
There are two groups of antipsychotics: atypical antipsychotics like Abilify and typical antipsychotics.
Abilify vs. typical antipsychotics
Typical antipsychotics, which are older, tend to block dopamine more than atypical antipsychotics. Examples include haloperidol, perphenazine, and prochlorperazine.
Atypical antipsychotics have more of an effect on serotonin, and they’re more common. They are less likely to cause serious movement problems as a side effect. These include tardive dyskinesia. They’ve also been found to be more effective for many conditions.
Abilify vs. other atypical antipsychotics
There are several atypical antipsychotics. Examples include:
Risperidone (Risperdal, Risperdal Consta)
Quetiapine (Seroquel)
Olanzapine (Zyprexa, Zyprexa Zydis)
Clozapine (Clozaril, Versacloz)
Lurasidone (Latuda)
Ziprasidone (Geodon)
Brexpiprazole (Rexulti)
Iloperidone (Fanapt)
Some notable differences between Abilify and other atypical antipsychotics include:
Abilify has more dosage forms than other atypical antipsychotics. This gives you a wide range of products that might work for you.
Abilify is FDA approved for conditions in kids and teens, who have few medication options. Not all atypical antipsychotics are approved for these ages.
Abilify is less likely to cause sexual problems than some other atypical antipsychotics. The reason may be that it doesn’t increase the hormone prolactin as much.
Abilify is less likely to cause weight gain than some other atypical antipsychotics.
Abilify causes fewer anticholinergic side effects than some other atypical antipsychotics. These side effects include dry mouth, drowsiness, and constipation.
Abilify may be more likely to increase blood pressure and impulse-control problems than other atypical antipsychotics.
When you start an atypical antipsychotic, like Abilify, tell your healthcare professional about other prescription and over-the-counter medications you take. This will help them check for Abilify interactions and prescribe a dose that’s best for you. After starting Abilify, tell your healthcare professional about any side effects. They can help you find the right dose.
The bottom line
Abilify (aripiprazole) is an atypical antipsychotic medication that treats mental health conditions. These include schizophrenia and bipolar 1 disorder. Abilify’s mechanism of action is to block and activate dopamine and serotonin receptors (binding sites) in your brain. These are brain chemicals that affect how we think, feel, and act.
Update your prescriber on your condition at follow-up appointments. If Abilify hasn’t started to improve your symptoms after 2 weeks, let your prescriber know. They may want to adjust your dose. But it can take several weeks or months to feel the full effects of Abilify.
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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