aripiprazole, Abilify (cont.)

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Quinidine (Quinaglute, Quinidex) inhibits another liver enzyme known as CYP2D6 that also breaks down aripiprazole and can increase the amount of aripiprazole in the body. The manufacturer of aripiprazole recommends reducing the dose of aripiprazole by one-half during quinidine therapy. Other medicines that block CYP2D6 include fluoxetine (Prozac) and paroxetine (Paxil).

Alpha-1 receptor blockers [doxazosin (Cardura), prazosin (Minipress), terazosin (Hytrin)], used for control of blood pressure and prostatic enlargement, may increase the chance of hypotension (unusually low blood pressure).

PREGNANCY: Aripiprazole has not been adequately studied in pregnant women. Neonates exposed to antipsychotic drugs in the third trimester may experience withdrawal symptoms and other side effects. The physician may choose to use aripiprazole if he or she feels that it its benefits outweigh this potential concern.

NURSING MOTHERS: It is not known if aripiprazole is excreted in breast milk; however, since most medicines are excreted in breast milk, it is recommended that women receiving aripiprazole should not breastfeed.

SIDE EFFECTS: Some of the most common side effects associated with aripiprazole are anxiety, blurred vision, constipation, cough, headache, insomnia, lightheadedness, nausea, rash, restlessness, runny nose, sleepiness, tremors, vomiting, weakness, and weight gain.

Long-term use of aripiprazole may lead to a potentially irreversible condition called tardive dyskinesia (involuntary movements of the jaw, lips, and tongue). A potentially fatal complex referred to as neuroleptic malignant syndrome has been reported with anti-psychotic drugs, including aripiprazole. Patients who develop this syndrome may have high fevers, muscle rigidity, altered mental status, irregular pulse or blood pressure, rapid heart rate, excessive sweating, and heart arrhythmias.

Although there is no clear link between aripiprazole and diabetes, patients should be tested during treatment for elevated blood-sugars. Additionally, persons with risk factors for diabetes, including obesity or a family history of diabetes, should have their fasting levels of blood sugar tested before starting treatment and periodically throughout treatment to detect the onset of diabetes. Any patient developing symptoms that suggest diabetes during treatment should be tested for diabetes.

Elderly patients with dementia related psychosis treated with antipsychotics are at an increased risk of death and aripiprazole should not be used for this indication.

Antidepressants increased the risk of suicidal thinking and behavior in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of aripiprazole or any other antidepressant in a child or adolescent must balance this risk of suicide with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thoughts, or unusual changes in behavior.

Reference: FDA Prescribing Information


Medically Reviewed by a Doctor on 7/29/2014


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