Aripiprazole

It can take a few days, or sometimes a few weeks, for aripiprazole to start helping you. You may not feel the full effects of the medication for four to six weeks, sometimes longer. It’s hard to be exact because aripiprazole works differently for each person.

If you have seen no change in any symptoms after two weeks, you should talk to your doctor about your progress. They may recommend increasing the dose or changing your medicine. Don’t increase your dose yourself if you think the medication isn’t working.

If you are starting on the long-acting injection (Abilify Maintena™), it can take a few days for the first injection to start working.

If you switch from aripiprazole tablets to the injection, you may need to continue taking your tablets for the first few weeks after your first injection, as the injection takes a few weeks to kick in. Your doctor will advise you on this.

Aripiprazole can cause both weight gain and weight loss, but it has a lower risk of weight gain compared to other antipsychotics.

Children and young people are more prone to this side effect than adults. But it's hard to predict how the medication will affect each person, so if you notice any changes in your weight while taking aripiprazole, consult your doctor or pharmacist.

Sometimes, aripiprazole is prescribed alongside other antipsychotics to manage symptoms and counteract weight gain caused by those medications. Your doctor should regularly monitor your weight while you are on aripiprazole.

Children and adolescents naturally gain some weight as they grow, but any significant weight increase should be carefully monitored. Mental health conditions like schizophrenia and bipolar disorder can make it harder to stay active and eat healthily, so it's important to seek advice from your doctor, pharmacist, or specialist healthcare team for lifestyle support.

Most weight gain, if it occurs, usually happens within the first six months of treatment, although it may continue at a slower rate afterwards, even with a low dose. People new to this type of medication may be more likely to gain weight, but it's impossible to predict how aripiprazole will affect someone before they start taking it.

Aripiprazole can also affect how your body processes sugar, leading to high blood sugar levels. While this is uncommon, it can contribute to the development or worsening of diabetes, particularly in young people, and may be associated with weight gain.

Be alert for symptoms that suggest your body is struggling to process sugar, like excessive thirst, frequent urination, or persistent fatigue. If you experience these symptoms or have other concerns, schedule an appointment with your doctor.

If you already have diabetes, aripiprazole may impact your blood sugar levels. Discuss this with your doctor, monitor your blood glucose regularly, and you may need to adjust your diabetes medication accordingly.

You may want to let your family and friends know you are taking aripiprazole so they can support you and help you look out for side effects.

Aripiprazole may make you feel very sleepy but may also make it hard to get to sleep.

Sleepiness has been shown to affect young people more than adults.

See how it affects you for the first few days of taking it.

Unless the medication makes you feel sleepy, it is best to take it at about the same time of day in the morning. Taking it in the evening can make it harder to get to sleep.

If you have been taking aripiprazole for more than a month and you continue to feel very sleepy during the day or your sleep at night is worse, you should go back to your doctor and discuss what changes could be made to help. This may include switching to a different medication.

Alcohol

You can drink alcohol in moderation while taking aripiprazole, but the two together could make you very sleepy.

During the first few weeks, it is recommended that you stop drinking alcohol until you see how the medicine affects you.

If you want to drink alcohol, it’s best to only drink small amounts and have a plan for getting home safely if you go out.

Drinking alcohol every day, or in large amounts, can make your symptoms worse and may mean you won’t get the maximum benefit from your medication.

Street drugs

Antipsychotics block the effect of dopamine, so this means the ‘high’ may not be as ‘high’ as before from any drug. You may be tempted to increase your dose of the drug to make up for it, but this could be dangerous.

Cannabis can make drowsiness worse with aripiprazole.

Cannabis and other drugs may have their own side effects on your mental health, like anxiety or psychosis.

Methadone can make drowsiness worse with aripiprazole.

Aripiprazole could reduce your craving for cocaine and could reduce the level of happiness that you feel when taking cocaine.

Aripiprazole and stimulant drugs such as amfetamines can affect the heart, and this can be dangerous when taken together.

There are many other street drugs, but we don’t know what effect taking them with aripiprazole will have, so it’s best to be cautious.

There is no regulation of street drugs or ‘legal highs’, so even if there are no known issues with the medication you take, the supply you receive might be mixed with other substances that could be dangerous.

Get more advice on drugs and alcohol.

Aripiprazole does not mix well with some other medicines, including herbal remedies.

Before you start taking aripiprazole, tell your doctor if you are taking any other medications, including things you have bought over the counter and topical applications that you put on your skin.

Look at the leaflet inside your medicine box for more information about other medicines that can interact with aripiprazole. With some medicines your doctor may need to adjust the dose of aripiprazole if you take them together. Ask a doctor or pharmacist for more information if you have any questions.

There are multiple companies that manufacture this medicine and the non-active ingredients may vary between products and also between the different strengths of tablets that are available.

Always let your pharmacist know if you have any food allergies or intolerances, and always check with them if you’re concerned about any of the ingredients in your medication.

The tablets contain lactose so they may not be suitable for you if you have problems eating some sugars or dairy products.

The orodispersible tablets contain aspartame, which can be a problem for people with a condition called phenylketonuria.

The oral solution (liquid) contains sucralose. This should not affect your blood sugar if you’re diabetic.

If you need to avoid animal products, please note that non-active ingredients used in the production of medicines may sometimes be of animal origin. Ask your pharmacist if you have any questions about the ingredients.

Further information about practical considerations for medicines if you need to avoid animal products can be found on the Vegan Society website.

Taking aripiprazole may make you feel very tired or dizzy and affect your eyesight when you start taking it.

This could affect you if you drive a car, ride a bike, or do anything else that needs a lot of focus. It might be best to stop doing these things for the first few days or weeks until you know how it affects you.

Most people drive as normal while taking aripiprazole. If you are worried about this or have any concerns you would like to discuss, speak to your doctor or pharmacist.

You must tell The DVLA (Driver and Vehicle Licensing Agency) if you have bipolar disorder, schizophrenia, schizoaffective disorder or other mental health conditions that could affect your driving. You can be fined if you do not tell DVLA about a medical condition that affects your driving and may be prosecuted if you are involved in an accident as a result.

Pregnancy

If you become pregnant while you are on aripiprazole, you should carry on taking it and make an appointment to see your doctor as soon as possible. They can discuss the benefits and risks of continuing aripiprazole and help you to make a decision that is best for you and your baby. They may refer you to a specialist perinatal mental health team to support you with this decision.

If you decide to carry on taking aripiprazole during your pregnancy, make sure your midwife is aware so they can advise on extra monitoring if appropriate. During pregnancy it is standard practice for your midwife to assess your risk of blood clots. There are lots of things that can increase risk, and blood clots are also reported as a rare side effect of aripiprazole. To reduce your risk of a blood clot, your doctor or midwife may advise on the use of medicine to prevent this.

Your dose may need to increase later in your pregnancy as the body gets rid of aripiprazole more quickly. After delivery, your dose will go back to what it was before.

If you are planning to get pregnant, it is recommended that you take folic acid while you are trying for a baby and during pregnancy. It is safe to take this together with aripiprazole.

You can find out more information about taking aripiprazole during pregnancy at Bumps (Best Use of Medicines in Pregnancy).

Remaining well is particularly important during pregnancy and while caring for a baby, so treatment with aripiprazole in pregnancy may be the best option for you.

Post-natal

There are some other symptoms that can occur in newborn babies if aripiprazole is taken in the last three months of pregnancy. Look out for these and get help if they happen:

• jerking or twitching of the muscles or a tremor
• being jittery, irritable or constant crying
• being too hot or cold
• suckling/ feeding difficulties
• having stiff or floppy muscles, or overactive reflexes
• being very sleepy or finding it difficult to sleep
• breathing problems

These are usually mild and go away in a few days without treatment.

If your medication makes you sleepy, do not go to sleep with your baby in the same bed, and be cautious when handling your baby (especially if waking during the night for feeds). Think about support from a partner or family member to help you if needed.

Breastfeeding

Aripiprazole is passed to the baby in breast milk in small amounts.
Aripiprazole can lower the level of a hormone in the body which is needed to produce milk. In some cases, this can lead to decreased milk production.

If your baby was premature or has health problems, then you will need to be extra careful about taking medicines while breastfeeding. It may be best not to breastfeed if this is the case, but you should discuss this with your doctor or midwife.

It is important for you to remain well while you are bonding with and looking after your baby. For this reason, it may be best to take medicine for your mental health when breastfeeding.

Talk to your midwife, doctor or pharmacist if you want to breastfeed while taking aripiprazole. Make sure that your doctor, nurse, or health visitor checks your baby for any side effects.

Sex

Aripiprazole is unlikely to cause side effects that affect your sex life and is also less likely to do so than other antipsychotic medications.

In rare cases, aripiprazole can cause a long-lasting and painful erection (called priapism). This is rare, but if this happens to you, seek urgent medical help.

Raised prolactin levels are a possible side effect of aripiprazole, although this is uncommon with this medicine, and less likely compared with other antipsychotic medicines. It is more common for aripiprazole to lower prolactin levels in the body.

If you have raised prolactin levels, this could cause the following symptoms:

• periods may become irregular or stop
• some breast growth and milk flow, regardless of gender
• decrease in libido (not feeling like you want to have sex)

It is also possible to have increased levels of prolactin and not have any symptoms.

Aripiprazole is more likely to lower prolactin levels. This is not thought to cause side effects that could affect your sex life although in rare cases it can cause erectile dysfunction (problems getting an erection or getting hard). It is unclear whether this is a side effect of aripiprazole or not.

If you do experience any side effects, they occur when you first start medication and improve over time. If they do not, and this is a problem for you, make an appointment to discuss this with your doctor.

Untreated illness can have a negative effect on your sex life, so if aripiprazole helps you to recover, positive effects can include improving your desire, experience and enjoyment of intimate relationships again.

Fertility

There is currently no evidence to show that aripiprazole directly affects fertility.

However, while uncommon with aripiprazole, a possible side effect includes increased levels of a natural hormone called prolactin in the body.

If you have raised prolactin levels (hyperprolactinaemia) this may affect your fertility, regardless of gender.

For people who menstruate, raised prolactin levels may cause problems with your menstrual cycle and you could miss periods (or they could become irregular or stop altogether). This means it may be more difficult to get pregnant.

Your doctor will monitor the levels of this hormone while you are taking aripiprazole.

Aripiprazole is less likely to cause raised prolactin compared to other antipsychotic medicines, and usually reduces levels of prolactin.

Aripiprazole is not a banned substance in sport.

Most people play sports as normal while taking aripiprazole. However, taking aripiprazole may make you feel tired and dizzy, and affect your eyesight. This could be dangerous in some sports, so it might be best not to take part in them for the first few days or weeks until you know how it affects you.

If you are worried that taking aripiprazole might make doing the sports you enjoy more difficult, discuss this with your doctor.

Ideally it is best not to take aripiprazole for the first time just before your exams.

Aripiprazole could make you feel very tired and dizzy, make you feel restless and affect your eyesight.

You should talk to your doctor about any future exams if you are starting aripiprazole. You might decide together to delay starting it until you have completed them.

If they are more than a week away, however, you might find that it is better to start aripiprazole to improve your motivation and ability to study.

Most people take exams as normal while taking aripiprazole. If you are worried that taking aripiprazole might make studying for or taking your exams harder, discuss this with your doctor.