How it works
What does aripiprazole do?
Aripiprazole is a ‘second-generation antipsychotic’ (sometimes described as an ‘atypical antipsychotic’).
Research suggests that mania and psychosis are more likely to occur when parts of the brain have too much of a chemical called dopamine. This theory is based on the fact that amfetamines, which are stimulants that release dopamine, can bring on psychosis in people who do not have the condition.
An antipsychotic medicine helps to adjust the levels of dopamine and other chemicals available in your brain. Aripiprazole reduces dopamine activity where it is too high, helping with symptoms like hallucinations. It also increases dopamine activity in areas of the brain where it is low, helping with symptoms like poor motivation.
How long does aripiprazole take to start working?
It can take a few days, or sometimes a few weeks, for aripiprazole to start helping you. You may not feel the full to effects of the medication for four to six weeks. It’s hard to be exact as aripiprazole works differently for each person.
If you have seen no change in symptoms after two or three weeks, you should talk to your doctor about your progress.
Your doctor needs to know if...
You need to talk to your doctor or pharmacist before starting treatment with aripiprazole if any of the following apply to you:
- you have high blood sugar (symptoms include being thirsty all the time, weeing a lot, decreased appetite and/or feeling weak) or if you have a family history of diabetes
- you have ever had seizures (fits)
- you have had strange muscle movements that you could not control, especially in the face
- you have heart problems, or you have a family history of heart problems
- you have had a stroke or "mini" stroke
- you have high or low blood pressure
- you have had blood clots, or you have a family history of blood clots
- you have ever been addicted to gambling
The tablets contain lactose so they may not be suitable for you if you have problems eating some sugars or dairy (milk-based) products.
The orodispersible tablets (melts) 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.
Check with your pharmacist if you’re concerned about any of aripiprazole’s ingredients.
You should only take aripiprazole as agreed with your doctor.
You can take aripiprazole as tablets, orodispersible tablets (melts), liquid or a long-acting monthly injection.
You will get the best effect from aripiprazole if you take it regularly.
Make sure that you know your dose. If it's not written on the label, check with your pharmacist or doctor.
You will usually take your dose once a day.
It doesn’t matter what time you take it each day – choose a time that you can always remember. This could be a mealtime, or when you brush your teeth.
You can take the tablets or liquid before or after food.
For the normal coated tablets, swallow them whole with a drink of water - if you chew them, they taste bitter.
To take an orodispersible tablet (melt), put one on your tongue and let it dissolve there. You can also dissolve it in some water if you prefer.
You cannot mix the oral solution with any drink or food. It must be taken on its own.
A doctor or nurse can give you a fast-acting dose of aripiprazole by injection if you are very agitated. You can have a tablet at the same time – under the supervision of a doctor – which will make the effect last longer.
If you start receiving the long-acting injection, you may also have be given some tablets to take until the medicine level is high enough in your body.
What if I miss a dose?
If you forget to take a dose, then just take it as soon as possible.
If you forget to take it by your next dose, only take the next dose.
Do not take a double dose.
What will happen if I forget to take my aripiprazole?
If you forget to take your medicine for a few days, you may start getting your old symptoms back. Talk to your doctor if this happens.
Stopping the use of aripiprazole
Stopping the medication causes the balance of chemicals in the brain to change.
Once you start taking an antipsychotic medicine, the brain adjusts to having a new level of dopamine around. If you stop taking it suddenly, the balance starts to change, and your old symptoms could return.
You could also experience some unpleasant withdrawal symptoms like headache, feeling sick and sleep problems.
You can stop taking aripiprazole safely with your doctor’s help. They will work with you to reduce your dose gradually rather than stopping suddenly. The speed at which you reduce depends on how unwell you were and how long you have been on aripiprazole.
The information on this page was reviewed by the College of Mental Health Pharmacy in March 2020.