Aripiprazole

The active substance is Aripiprazole.

what is aripiprazole?

• Aripiprazole inhibits delusions, hallucinations and tics.
• With psychoses, such as with schizophrenia, and with mania. Sometimes also with anxiety, depression and tics.
• It works within hours and for about a day.
• Take the tablets with half a glass of water.
• In schizophrenia, severe agitation or tics, the use is usually several years.
• In mania or psychosis due to depression, the use is usually during the manic or psychotic period.
• Side effects that may occur: a feeling of emptiness, restlessness, headache, sexual disturbances and gastrointestinal complaints. Consult your doctor if this affects you.
• You may experience movement disorders such as twitching, stiff muscles and inability to sit still. Then consult your doctor.
• You may become blurred or drowsy, sleepy or dizzy. Do not drive for the first few days and after that as long as you continue to experience these side effects. Watch out with alcohol. This can make you even drowsy.
• Have you been using aripiprazole for a few weeks? Don’t stop all at once. Decrease it slowly in consultation with your doctor or pharmacist.
• Are you pregnant? Or do you want to get pregnant? Ask your doctor if you can take this medicine.
• Are you breastfeeding? Or do you want to breastfeed? Ask your doctor if you can take this medicine. This drug passes into breast milk and can be bad for the baby.

what is aripiprazole used for?

Aripiprazole belongs to atypical antipsychotics . It reduces the effect of naturally occurring substances, mainly dopamine, in the brain. This, among other things, reduces psychoses.

Doctors prescribe it for psychosis, schizophrenia, mania, depression, anxiety and tics .

Psychosis

Symptoms

• In a psychosis one experiences oneself and the world around them differently from reality. We then speak of delusions and hallucinations.
• Psychotic people often distrust their environment and are confused. Psychosis can be very frightening for both the patient and the environment.

Causes

• Psychoses can occur in various situations, for example in schizophrenia, depression, during mania in manic depression, in dementia, alcohol withdrawal, extreme anxiety or in poisoning such as alcohol, drugs and some medicines.
• In the latter cases it is also often referred to as a delirium. Delirium lasts much shorter than psychosis.

How

• Aripiprazole works reduces the symptoms of psychosis or delirium. A tablet works within hours.
• An injection within 1 hour. One dose is effective for approximately 24 hours.

Schizophrenia

Symptoms

• Schizophrenia is a psychological disorder with disorders in thinking, perception and emotional life. The main symptoms in schizophrenia are psychosis and confusion.
• In a psychosis one experiences oneself and the world around them differently from reality. We then speak of delusions and hallucinations.
• People with schizophrenia often also feel depressed, anxious, guilty or tense, which makes them neglecting themselves, making social contacts difficult and isolating themselves from the outside world. These are called the ‘negative phenomena’ of schizophrenia.

Effect

• Aripiprazole reduces the effect of naturally occurring substances in the brain, such as dopamine. This suppresses the symptoms of psychosis. But it hardly works against the ‘negative phenomena’.
• Aripiprazole reduces the symptoms of one of a psychosis. A tablet works within hours. An injection within 1 hour. One dose is effective for approximately 24 hours.

Mania

Phenomena

• Mania is a period of exaggerated cheerfulness, with many unrealistic plans and actions. People often get into debt during this time and engage in activities that they later regret. Sometimes they also suffer from delusions and hallucinations.
• Usually mania occurs in someone who has manic depression. In this disease, severe depressive periods alternate with manic periods.
  Sometimes they occur more or less simultaneously and one also has feelings of depression during the manic period.

Treatment

• For mania, doctors prescribe lithium or valproic acid, or an antipsychotic such as aripiprazole. Sometimes both are combined.
• If this drug works well for you, the doctor may also prescribe it to prevent or level off another mania.

Action

• The sedative effect of aripiprazole tablets sets in within a few hours. If rapid action is required, an injection is given and works within an hour. The duration of action of 1 dose is approximately 24 hours.

Depression

Symptoms

• In manic depression, depressive periods alternate with manias (see also the text above).
• In depression there is a dark mood, loss of interest and pleasure in the things of life. Someone who is depressed often feels worthless and has feelings of guilt. People with depression can also be easily irritated and have difficulty falling or staying asleep.
  Delusions and hallucinations sometimes occur in very severe depression (see ‘psychosis’ above). This is also called psychotic depression.

Treatment

• Aripiprazole can be used in combination with antidepressants in psychotic depression. Above you can read how aripiprazole works for psychoses.

Unrest

Psychiatric conditions such as autism and brain damage can sometimes make children or adults very restless, aggressive or anxious.

Treatment

• If this cannot be properly controlled in another way, doctors prescribe relaxing medicines. This is usually an antipsychotic, such as risperidone, olanzapine or aripiprazole.

Effect

• Aripiprazole reduces anxiety, anxiety and aggressiveness within a few hours. The duration of action of 1 dose is longer than 24 hours.

Tics

Symptoms

The syndrome Tourette has been suffering from, which is repeated movements or twitching of the face, shoulders or arms, and making noises, such as sniffing, growling or compulsive swearing.

How

• Aripiprazole works sometimes helps to reduce these symptoms. It also affects anxiety and the compulsions of Gilles de la Tourette syndrome.
• The duration of action of 1 dose is longer than 24 hours.

what is aripiprazole side effects?

In addition to the desired effect, this can cause drug side effects.

The main side effects are the following.

Sometimes (affects 10 to 30 in 100 people)

• Flattening of the emotional life , loss of initiative and activity, feeling trapped and a feeling of emptiness.
• Movement disorders . The side effects may resemble the symptoms of Parkinson’s disease: stiff muscles, shaking, difficulty walking or speaking, restlessness and sudden muscle twitching. Tell your doctor about these symptoms. The elderly, people with Parkinson’s disease and people who already have movement disorders are extra sensitive to this side effect. If you notice this, notify your doctor. Very rarely, if you take this drug for a long time, you may develop any other type of movement disorders similar to tics. Such as strange movements of the tongue and mouth, such as smacking, sucking or chewing, and strange facial expressions. Further flexion and extension of fingers and toes, swinging and twisting movements of shoulders and pelvis. If you take this drug for a long time, these side effects are more likely.
  If you notice movement disorders, talk to your doctor. Sometimes your doctor may lower the dose or prescribe a different medication that will help reduce your symptoms. Medicines are also possible that counteract movement disorders.
  Consult your doctor if you have Parkinson’s disease or if you already have a movement disorder . The symptoms may be made worse by this medicine. The doctor may be able to prescribe a different medication.

Rare (affects 1 to 10 in 100 people)

• Headache, sleeplessness and depression .
• Gastrointestinal complaints , such as nausea, heartburn and stomach pain. These side effects occur mainly at the beginning of the treatment. It usually helps if you take the medicine with some food. Does it continue to bother you after a few days? Then contact your doctor.
• Constipation (constipation). Eat fiber-rich food and drink a lot.
• Drooling , especially during sleep. Consult your doctor if this is a problem for you.
• Dry eyes, blurred vision and very rarely double vision and light shyness. If you have Sjögren’s syndrome , a condition in which the mucous membranes of the eyes and mouth, among other things, are drier than normal: you may develop more complaints. This drug reduces the production of tears and saliva. Contact your doctor if you have more eye irritation or dry mouth.
• Feeling weak .
• Drowsiness, drowsiness, dizziness and a decrease in the ability to react, concentrate and coordinate. Prevent accidents in traffic as well as other activities at home and at work, such as when climbing a ladder, operating appliances, and monitoring or checking something at work. Even if you have to get out of bed at night to go to the toilet, you may have less control over your muscles and therefore fall faster.
• Problems with making love . In men: more difficult to get an erection. In women: more difficult to get an orgasm. Very rare in men and women: more desire to make love.
• Weight gain , due to an increase in appetite and an altered metabolism or weight loss .
  Because the weight gain is partly due to an increase in appetite, it is important to eat less than you would like. That is very difficult for many people. If you are gaining or losing too much weight, see your doctor or a dietitian. They can help you deal with this.
• Urinary problems , due to less control over the muscles of the bladder. As a result, you may experience involuntary leakage of urine, but also have difficulty urinating or emptying the bladder completely. These complaints worsen with an enlarged prostate. Urine remaining in the bladder also increases the risk of cystitis. If you experience problems urinating, contact your doctor. The complaints usually disappear when you have become used to this medicine.
• Heartbeat too fast and palpitations very rarely .

Very rare (affects less than 1 in 100 people)

• An increased risk of cardiac arrhythmias . You may experience sudden dizziness or become unconscious for a short time. This is especially important for people with a certain heart rhythm disorder, namely the prolonged QT interval . Do NOT take this medicine if you have this heart rhythm disorder. Consult with your doctor. You may be able to switch to another drug.
• Dizziness , especially when getting up from bed or a chair. This generally passes once your body has adjusted to the drug. This is usually within a few days to weeks. If you feel dizzy, do not get out of bed or a chair too quickly. It is best to lie down and put your legs a little higher, for example on a pillow. If you continue to have problems, discuss this with your doctor. You may be able to take the medicine in the evening, so that you will have less dizziness during the day.
• Neuroleptic Malignant Syndrome . This can be seen in unexplained fever, very stiff muscles, drowsiness, palpitations and severe sweating. If you have these symptoms contact your doctor immediately. If it occurs, it is usually during the first 2 weeks of use or within 2 weeks of a dose increase.
• Blood clots in the bloodstream ( thrombosis ). This increases the risk of vascular disorders, such as a thrombosis or stroke. The signs of thrombosis may include painful swelling of the leg or sudden shortness of breath. Contact your doctor immediately if you have these symptoms. People who have previously had thrombosis or who are taking medicines against thrombosis are more likely to have this. This can be recognized by a thick, hard, red and painful spot on the leg, sometimes pain in the calf and a feeling of heaviness in the leg, rarely sudden shortness of breath, sometimes with pain or coughing up blood. In these cases, contact a doctor immediately or go to the Emergency Service immediately.
• A seizure can be triggered in people with epilepsy . Talk to your doctor about whether you can use this medicine.
• Too much cholesterol and other fats in the blood. These can accumulate in the blood vessels, causing thrombosis (see Very rare). Your doctor will check your cholesterol and / or fat levels annually and more frequently during the first year of treatment. If you already have high cholesterol and / or fat levels in your blood, your doctor will check you closely for this.
• Swallowing difficulties. You may choke. When choked, food can pass into the trachea instead of the esophagus. You can get pneumonia because of this. Contact your doctor if you find that you have difficulty swallowing.
• Liver disorders . You may notice this by a tender, swollen abdomen or yellowing of the whites of the eyes or of the skin. Then notify a doctor.
• Hair loss and hypersensitivity to sunlight .
• Blood disorders . If you get unexplained fever, sore throat or blisters in the mouth and throat, sudden bruising or nosebleeds, it could be signs of blood disorders. Then notify your doctor.
• Hypersensitivity to this drug. You will notice this by hives or itching. Consult your doctor in case of these symptoms. Tell the pharmacy that you are hypersensitive to aripiprazole. The pharmacy team can then ensure that you do not receive the medicine again. Rarely, angioedema develops: a swelling of the face, lips, mouth, tongue or throat. You can get very short of breath. If this happens, see a doctor or go to the emergency room immediately.

Consult your doctor if you experience too much of any of the above side effects or if you experience any other side effects that worry you.

There are many different types of antipsychotics. These have the same effect, but different side effect patterns. A different antipsychotic may be more suitable for you.

Do you suffer from any side effect? Report this to the lareb side effect center. All reports about side effects of medicines in the Netherlands are collected here.

Explanation of frequencies

• Regular : affects more than 30 in 100 people
• Uncommon : affects 10 to 30 in 100 people
• Rare : affects 1 to 10 in 100 people
• Very rare : affects less than 1 in 100 people

How do I take this medicine?

How?

• Ordinary tablets : take with half a glass of water or with another drink.
• Injections: These will be administered by the doctor or nurse into a buttock muscle or shoulder muscle.

How long?

Schizophrenia

When the psychotic period is over, you will usually have to use this medicine for a long time to prevent another psychosis. The doctor will usually reduce the dose during that time.

• If you have had psychosis for the first time, you will usually need to take this medicine for 1 or 2 years after your recovery, before you can try to stop. Only in exceptional cases, when you have recovered very quickly, can you try to stop six months after recovery. This must be done under proper supervision and the chance of relapse is still greater.
• If you have had a psychosis before, you will usually need to take an antipsychotic medication for the rest of your life.

Mania and depression

• When the worst troubling symptoms have disappeared, the doctor may advise you to gradually taper off the use of aripiprazole. You usually still need to keep taking lithium or valproic acid, or the antidepressant. Sometimes the doctor recommends that aripiprazole be continued to prevent another mania or depression.

Anxiety

• Aripiprazole is usually used for several years by people with severe anxiety, aggressiveness or anxiety, such as people with dementia, the mentally handicapped and people with autism. The dose is usually reduced when the symptoms decrease.

Tics

• If the drug is working properly, you usually need to keep taking it for several years.

Can I drive a car, drink alcohol, and eat or drink anything with this medicine?

driving a car?

• It can be dangerous to participate in traffic while taking this medicine. This is due to side effects such as drowsiness, sleepiness, dizziness and blurred vision. You should not drive for the first few days of taking this medication. Also, do not drive a car if the dosage increases. Only after taking the same dose for a few days should you be allowed to drive again.
• After a few days, most people have become sufficiently used to the effects. You may then drive again. But only do that if you no longer suffer from the side effects.

Note: psychoses, schizophrenia, mania or severe depression can also be reasons why you are not allowed to drive. Consult with your doctor if this is the case for you. Would you like more information about driving with certain conditions? Then take a look at the website of the CBR .

drinking alcohol?

• Alcohol enhances the narcotic effect of this drug. Even if you no longer notice this because you have gotten used to this medicine, alcohol can make you very drowsy. Therefore, limit the use of alcohol and rather not drink it.

eat everything?

• There are no restrictions for this with this medication.

aripiprazole interactions with other drugs

This drug interacts with other drugs. The text below only lists the active ingredients of these drugs, not the brand names. You can check whether your medicine contains one of these active substances in your package leaflet under the heading ‘composition’.

The drugs with which the main interactions occur are the following.

• Other drugs that reduce reaction time. These medicines often have a yellow warning sticker on the packaging
• Many medicines for Parkinson’s disease and aripiprazole reduce each other’s effect. Consult with your doctor if you are experiencing delusions and hallucinations. The doctor may be able to lower the dose of one of the medications or choose a different antipsychotic that has less of this interaction.
  If you are going to take both medications: consult your doctor if you experience delusions and hallucinations (again) or if the symptoms of Parkinson’s disease get worse.
• Bupropion , a drug for smoking cessation, fluoxetine and paroxetine , medicines for depression, and quinidine , a medicine for heart rhythm problems. The amount of aripiprazole in the blood increases. You may experience more of the side effects of aripiprazole. Discuss this with your doctor.
• The antifungals itraconazole and ketoconazole. The amount of aripiprazole in the blood increases. This increases the risk of side effects. Discuss this with your doctor. Your doctor may prescribe a different medication. If this is not possible, your doctor will monitor you more closely.
• Some HIV medications . Ask your pharmacist which medicines this concerns.
• Some cancer drugs . Ask your pharmacist which medicines this concerns. The effects or side effects of these drugs may change. Discuss this with your doctor.

The following medications may cause aripiprazole to disappear from the body more quickly. It is then no longer effective. Contact your doctor if you are taking any of the following medications.

• The anti-seizure drugs carbamazepine, phenobarbital, phenytoin and primidone.
• The tuberculosis drugs rifabutin and rifampin.
• St. John’s wort (hypericum), a herbal remedy for depression. Consult with your doctor.

Not sure if any of the above interactions are of interest to you? Please contact your pharmacist or doctor.

Can I use this medicine if I am pregnant, planning to become or breastfeeding?

Pregnancy

• Tell your doctor and pharmacist as soon as you are pregnant or plan to become pregnant soon. You can safely use this drug during the first 6 months of pregnancy (1st and 2nd trimester). Problems can arise when used during the last 3 months of pregnancy (3rd trimester). The child may then suffer from movement disorders and withdrawal symptoms after birth. This can be seen, for example, in poor drinking and crying a lot. But not treating your disease can also harm you and the baby. Psychosis during pregnancy poses more risks to you and the baby than taking this medicine. So talk to your doctor about the pros and cons.

Breastfeeding

• If you want to breastfeed, talk to your doctor. The drug passes into breast milk and may harm the baby. You may be able to switch to a different medication. A medicine that is known to be safe to use.
• Are you on prescription or over-the-counter medications? Would you like to help increase knowledge about medication use during pregnancy and breastfeeding? Then report your experience to pREGnant .