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Abilify (Aripiprazole) Side Effects, Withdrawal and FAQs

Abilify is a third-generation atypical antipsychotic medication used in the treatment of adult schizophrenia, bipolar 1 disorder, Tourette syndrome, and in young children (age restrictions apply) presenting symptoms associated with Autistic Disorder, such as temper tantrums, mood swings and aggression.

Abilify (aripiprazole) research has accumulated a significant body of data from clinical trials on various age groups and populations over the time the drug was first developed in the late 1990’s and released in the US in 2002.

Some side effects of aripiprazole led to the FDA placing a black box warning that restricted prescribing the drug within certain populations or age groups. (6)

Find more information on topics such as side effects, withdrawal adverse effects and other frequently asked questions below.

What is Abilify (Aripiprazole) Used For?

The drug is used primarily in the treatment of schizophrenia, bipolar disorder and major depressive disorder in adults.  The FDA expanded approved uses to include acute mania and mixed episodes (a combination of manic and depressive symptoms), in adults as well as in children who are at least 10 years of age. Elderly patients with signs of dementia should not take Abilify, as stated in the FDA black box warning regarding an increased risk of death in that population. (6)

Abilify was also approved in 2009 for use in children aged 6 and up with autism. Studies show a reduction in irritability, hyperactivity, inappropriate speech and aggression associated with autism, but an increase in weight gain, tremors, sleepiness and drooling. There are no long term studies to show safety over long term use of Abilify in young children.

In the treatment of acute manic/psychotic episodes, Abilify is considered a maintenance medicine, and is usually minimally prescribed for a period of 1-2 years.

Abilify is prescribed for these conditions:

  • Schizophrenia (impaired perceptions of reality vs unreality, paranoia, difficulty in relating or connection to others, etc.)
  • Bipolar disorder
  • Borderline personality disorder (an emotionally distressed state characterized by intentions to self harm, fear of abandonment, intense mood swings, explosive anger, etc.)
  • Tourette syndrome (characterized by vocal or muscle tics, repeating phrases, movements, etc.)
  • Autism (a condition in children characterized by emotional outbursts, lack of speaking or ability to articulate, social withdrawal, etc.)
  • Schizoaffective disorder (mood swings and disconnection from reality)
  • MDD, or major depressive disorder (severe depression that lasts over a long period of time)
  • OCD, obsessive compulsive disorder (characterized by repeatedly checking or counting objects or other compulsive motions/actions, etc.)
  • Mania/ manic episodes/ psychotic episodes (delusions, extreme euphoric state, impulsive behaviors that could involve harm to self or sometimes others)
  • PTSD, or post traumatic stress disorder (flashbacks or re-experiencing effects from past traumatic events triggered by present environment)
  • Agitated State (unpleasant state of aroused negative emotions, confusion, etc.)


Abilify (Aripiprazole) Alternative Names and Slang

Abilify is a trade name for the generic drug, aripiprazole or aripiprazole systemic. Other brand names for the drug include:

  • Aristada
  • Abilify Maintena
  • Aristada Initio

Abilify has not developed any significant demand or presence as a street drug, with the exception in possible cases of diversion, a potential outcome which is shared by all pharmaceutical products in general.

Abilify (Aripiprazole) Side Effects

There are some commonly reported side effects of taking Abilify which may fade within a short time. However, if these reactions linger or worsen, they should receive immediate medical attention:

  • Agitation
  • Dry mouth
  • Indigestion
  • Irritability
  • Heartburn
  • Lightheaded feeling
  • Rash
  • Restlessness, need to keep moving
  • Tremors
  • Sleepiness
  • Nausea
  • Vomiting
  • Constipation
  • Insomnia
  • Cold-like symptoms like runny or stuffy nose, sneezing, etc.
  • Fatigue
  • Dizziness
  • Stomach pain
  • Shakiness
  • Hyperventilation
  • Sore throat
  • Anxiety, fear
  • Headaches
  • Weight gain
  • Blurred vision
  • Any of the above if severe or lingering needs medical attention.

Side effects that are more severe can less commonly present, and require medical intervention immediately should they occur, including the following:

  • Seizures
  • High fever
  • Blood pressure fluctuations, high or low
  • Difficulty with speech or articulation
  • Rolling tongue
  • Sweating (profuse)
  • Drooling, excess salivation
  • Swelling of hands, feet, bloating in the limbs, etc.
  • Tachycardia (pounding heartbeat, racing heartbeat)
  • Loss of balance
  • Joint pain
  • Tingling or numbness in the extremities
  • Inability to move
  • Rash, blistering rash or ulcers that develop in mucous membranes
  • Trembling muscles, jerking motions, spasms
  • Muscle stiffness, rigidity
  • Uncontrolled facial motions
  • Twisting body or limb motions (involuntary)
  • Loss of bladder control
  • Lip smacking, puffing of the cheek muscles
  • Extreme tiredness
  • Sudden loss of consciousness
  • Akathisia combined with suicidality
  • Other involuntary muscle movements, repetitive
  • Tardive dyskinesia (very rare) usually irreversible

Aripiprazole is a third-generation type of antipsychotic medication, thought to be better tolerated than conventional or earlier antipsychotic drugs. Nonetheless, severe or persisting side effects should be monitored carefully and given medical attention if needed, without delay. (1)

Abilify (Aripiprazole) Withdrawal Symptoms

Abilify is associated with some adverse withdrawal effects and should never be abruptly discontinued. Slowly reducing the dosage over an adequate time frame is the recommended process for coming off the drug. (2)

According to studies published by NIMH, withdrawal symptoms for Abilify can include the following:

  • Nausea
  • Feeling lightheaded
  • Tachycardia
  • Anxiety
  • Diaphoresis (excessive sweating involving the entire body)
  • Insomnia
  • Headaches
  • Tremors, shakiness
  • Flu-like symptoms

These withdrawal symptoms may range from mild to severe, and a person may experience one or multiple concurrent symptoms during cessation or tapering from the drug.

Discontinuing/Quitting Abilify (Aripiprazole)

Discontinuing or quitting Abilify (aripiprazole) can be best done by gradually tapering off the drug, with medical oversight and guidance. Symptoms may develop to a severe and intolerable level. The preferred approach if possible would be to taper while in residential care.

Aripiprazole has a half-life of 75 hours, and the half life of its active metabolite “dehydro-dripiprazole” is 94 hours. It was at one time thought that due to the drug’s long half-life, that withdrawals would not likely emerge on abrupt cessation, but this was not always found to be the case in more recent trials and research done. Sometimes even on abrupt cessation there is a delayed onset of symptoms, which can nonetheless be quite hard to tolerate, unless proper support is in place.  Therefore the medical recommendation is to taper gradually from antipsychotic medications.  (2)

Abilify (Aripiprazole) FAQs

Here are some of the most frequently asked questions about Abilify and aripiprazole. For more information please contact us and we will freely offer any other available information on these or other topics of interest on request.

What Does Abilify (Aripiprazole) Do To The Brain?

The exact mechanisms of action on the brain of aripiprazole are not completely known or understood.

Aripiprazole acts in different ways than other types of antipsychotic medications; it can produce a modulating effect on certain neurotransmitters and their action along various pathways. (4)

Can You Get Pregnant on Abilify (Aripiprazole)?

Pregnancy is a very personal health matter, and an important one to discuss with your primary caregiver, especially when your pregnancy may overlap starting or stopping medication. As with all medications, gold standard medical advice is that gradual cessation is the safest procedure.

Always speak with your medical advisor so that an informed decision can be made regarding your and your child’s optimum health.

Is Abilify (Aripiprazole) Dangerous?

Abilify is a third generation antipsychotic medication. Though rare side effects are associated with any medication, Abilify is considered one of the least likely to produce severe reactions or withdrawal phenomena even after dependence to the drug has developed over the long term. (4)

Does Abilify Increase Dopamine?

According to a 2015 study prepared by NIMH, Aripiprazole may bind to certain receptors in the brain, and trigger a number of responses that modulate dopamine in various ways, sometimes increasing or even decreasing transmission of dopamine (and perhaps other neurochemicals) along certain pathways. This “adaptive” mechanism of dopamine modulation relates in particular to the mechanism of Aripiprazole and not necessarily to other antipsychotic medications. (4)

There is a theory of schizophrenia that overactivity of the area of the brain referred to as the  “mesolimbic pathway” may contribute to symptoms of schizophrenia such as delusions and hallucinations.  Therefore, a suggested corollary seems likely, that decreasing mesolimbic pathway activity (such as suggested by ongoing pharmacology research) can reduce symptomology associated with schizophrenia. (3)

A 2005 study on mouse brain activity reported by NIMH showed that aripiprazole increased dopamine and did not increase other neurotransmitters such as serotonin or norepinephrine. The 2015 study gives a more expanded and optimistic view on managing dopaminergic activity with Abilify. More research is needed in regards to continuing to make improvements in the treatment of schizophrenia. (4) (5)

Research Notes on Dopamine, Withdrawal and Bipolar

On genetic studies we have performed clinically at the Alternative to Meds Center, we have seen an association with the COMT (catecholamine methyl transferase) genetic polymorphism and certain conditions involving psychosis, mania, and features of high and low moods as described by the term bipolar.

A potential theory to explain this correlation could be due to the way that the biological pathways for catecholamines function. Catecholamines include dopamine, norepinephrine, and adrenaline, each of which performs an excitatory response to the limbic system, also known as the emotional brain.

Dopamine is associated with the perception of reward. A person with low sense of reward may be attracted to stimulants, and a person with an overly high sense of reward may present as manic.

The enzyme COMT can degrade dopamine and other neurotransmitters. However COMT impairment inhibits its ability to break down dopamine. Where genetic testing shows a presence of COMT genetic polymorphism, it would stand to reason that the person could be suffering from a dopamine excess. Thus, genetic testing can provide valuable information that can assist with helping someone to normalize or regulate neurotransmitter function.

The methionine variant results in a more sluggish COMT enzyme, which may leave dopamine around the prefrontal cortex for a longer period of time. (6)

More research studies are encouraged on this particular point, particularly considering that the aforementioned study is referring to the breakdown of dopamine in the prefrontal cortex as opposed to the striatum structures such as the caudate, putamen, and mesocorticolimbic regions.

Abilify is believed to have the capacity to deflect dopamine from the D2 receptor, and therefore, reduce manic symptoms.  Unfortunately, most drugs have limitations due to the adaptations of the body. The body, perceiving a dopamine deficiency can then make more receptors for dopamine. This usually makes an antipsychotic withdrawal the most challenging of all drug classes, including heroin and benzodiazepines.


Treatment for Abilify (Aripiprazole) Abuse and Addiction?

When the antipsychotic medication is reduced, based on existing theories about these drugs potential action of restricting dopamine, dopamine expression will begin to return. This formerly restricted dopamine now flooding into up-regulated receptors often clinically presents as a rapid expression of manic symptomology.

In many cases, the patient may become enchanted with the new found sense of reward which could result in resistance to either slowing down the medication taper, or increasing the dose to regain stability. This unwillingness to take pragmatic guidance makes this situation very labile and requires expert management.

Working closely with a doctor or center that has hospital admission privileges is highly advised as regaining control in a humanistic way may prove necessary. It is much better in extreme cases to have the individual safe and hospitalized under a trusted doctor’s admission, so that later, slower tapering efforts may be investigated.

An involuntary commitment or incarceration erupting from a situation where the tapering was either too rapid or otherwise unstructured or unsupported is certainly not a good outcome.

These considerations are especially relevant in cases where the medication has been relied upon for many years. Done well, certain dispositions can transition to being medication free or to the lowest possible dose that provides the highest quality of life successfully, which is our goal at the Alternative to Meds Center.

When Abilify (aripiprazole) medication is taken over a long period of time, as is usually the case with such prescription drugs, dependence will likely have developed, resulting in many possible discomforts associated with cessation. It may be prudent to select an inpatient program that is well equipped both in understanding the unique problems with antipsychotic drug withdrawal and also can provide comfortable, personalized assistance while withdrawing from the drug.

Our program involves multiple methods and therapies that can significantly reduce the stress that may otherwise could make the process seem and feel more difficult and time consuming than it has to be.

Using nutritional testing and support, toxic load removal, counseling, physical exercise, and many other therapeutic approaches to support the process in a beautiful and restful setting, we can help the body to ease back to a healthier state, and move toward the goal of normalizing the neurochemistry for better natural mental health. Contact us for more information on this important area of healthcare, and you may find you are closer than ever to be able to take the next step to full recovery from dependence on antipsychotic medications in a safe, nurturing and comfortable setting at the Alternative to Meds Center.

This content has been reviewed, and approved by a licensed physician.

Dr. John Motl, M.D.

Dr Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona.  He holds a Bachelor’s of Science degree with a major in biology and minors in chemistry and philosophy. He graduated Creighton University School of Medicine with a Doctor of Medicine.  Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.

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