What we’ve said about Aripiprazole

“It is probably the number one augmenting agent at a low dose for depression, proper depression when added to an antidepressant, but by itself doesn't really help in bipolar depression”

“The best evidence goes to ECT, TMS, TMS. antipsychotics, particularly aripiprazole has the best evidence and the biggest effect size, lithium, thyroid supplement, and the ketamines, esketamine and ketamine. So those would be our top line interventions”

“So you can see there, I kind of draw the line starting with Abilify. Abilify, while still having his weight gain, reasonably less of the proportion than most people. But you can see I'm pretty aggressive. I do not want to try anything above Abilify unless I really have to”

“keep in mind that there's some theory that for Abilify it may work better in people who have a more non-disturbed dopamine system meaning earlier in the disease course or not too much long-term stimulant use”

“Do not dose-abilify above 5 mg if what you are trying to do is trying to treat major depressive disorder without psychotic features. Do not do it. Just don't do it. It's not worth it”

“You should probably start around 15 and no lower than 10 milligrams. I've seen people respond with lower, but remember, what does that partial agonist mean? It basically means that about 20% of the dopamine receptors that it is bound to is not blocking”

“Abilify. Keep in mind that with Abilify, they did minimum 15 and all the way up to 30 to get the antipsychotic response in the original trials. And they gave it benzodiazepine as well”

“it's got a three-day half-life. Whenever you're thinking about half-life, that means steady state you have to multiply by five because it takes five half-lives to get there, so steady state takes two weeks”

“Aripiprazole is one of those medications that I'm more likely to dose in the morning because stimulation can outweigh sedation for a lot of patients”

“So if you have a patient that skips several of their doses every week but is still taking their medications several times a week, don't be afraid to use a higher dose Abilify. Let's say they're stable on Abilify 15 in the hospital. We'll give them Abilify 30 and they take it three or four times a week”

“2D6 inhibitor, and thus can be used to increase effective dose of your Abilifying antenna and Aristata, which maxes out at a 15 to 20 milligram daily dose”

“We've all seen patients gain a ton of weight on aripiprazole. I do think women are affected significantly worse than men. Most of the patients that I've seen gain a ton of weight tend to be women”

“It can actually lower antipsychotic induced prolactin because even though it's a partial agonist, it binds first before the other antipsychotics”

“I probably would have put it into A tier when I was younger, but having tried to use it a lot because of its favorable side effect profile, it's simply not efficacious enough”

“Brexpiprazole or Rexulti is essentially Abilify, but harder to dose because it comes in smaller milligram increments, in my opinion, and way more expensive”

“I really hate the practice of adding it to Haldol. You're basically making the medications fight each other because it binds so tightly to dopamine receptor that it essentially counteracts a lot of other antipsychotics”