How Long Does Abilify Take to Work?
Medically reviewed by David Snyder, PharmD
Abilify (aripiprazole) is an atypical (second-generation) antipsychotic used to treat certain mood disorders, such as depression and bipolar disorder, and some symptoms of schizophrenia. It's also used to treat Tourette's disorder and irritability related to autism.
The active ingredient in Abilify is aripiprazole. It's available in several forms, including orally administered (taken by mouth) tablets and solution (a type of liquid), a tablet that dissolves in your mouth, and an injection given into your muscle.
Abilify is approved by the Food and Drug Administration (FDA) for use in adults and children ages 6 years and older. However, the approved age for use varies based on the condition you're using Abilify to treat.
How long Abilify takes to work can vary based on certain factors, including the form of Abilify you take.
This article will describe how Abilify moves through your body, safe ways to take this medication, potential side effects, and more.
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Mood Disorders in America
Mood disorders are a category of mental health conditions that affect your overall emotional state. They are typically divided into two types: depressive disorders and bipolar disorder.
Examples of depressive disorders include major depressive disorder, postpartum depression, and persistent depressive disorder. Bipolar disorder is often categorized as bipolar 1, bipolar 2, or cyclothymia.
Mood disorder diagnoses, specifically depression, have been rising in the United States. In 2020, an estimated 20% of adults in the United States reported having been diagnosed with depression at some point in their life. According to a recent Gallup survey, that number has now risen to 23%.
Mood disorders are not curable. However, symptoms can be managed with a combination of psychotherapy (talk therapy) and medications.
Drugs commonly used to treat mood disorders include antidepressants, such as Prozac (fluoxetine) or Zoloft (sertraline). Healthcare providers may also prescribe mood stabilizers, such as Lithobid (lithium), or antipsychotics, such as Abilify.
What Is Abilify?
Abilify is an antipsychotic available in the following forms:
Oral tablet
Oral solution
Tablet that dissolves in your mouth
Intramuscular injection (an injection given into your muscle)
The active ingredient in Abilify is aripiprazole.
All the oral forms of Abilify, including the tablets that dissolve in your mouth, are available in a generic version called aripiprazole.
Alternative Brand-Name Forms of Abilify
Abilify is available in other forms that differ somewhat from the standard forms. They also have different brand names. These include:
Abilify Asimtufi: This is an extended-release intramuscular injection typically used once every two months. With extended-release products, the medication is released into your body slowly over time. Similar to the regular Abilify injection, Abilify Asimtufi is approved to treat schizophrenia in adults. It's also approved to treat bipolar 1, which is not an FDA-approved use for the standard Abilify injection.
Abilify Maintena Kit: Abilify Maintena Kit is an extended-release intramuscular injection similar to Abilify Asimtufi. It's approved for the same uses, but the Abilify Maintena Kit is typically dosed once per month instead of every two months.
Abilify Mycite Kit: This kit contains Abilify oral tablets embedded with an ingestible sensor to track when the medication is taken. It also includes a wearable patch that detects signals from the sensor. The system is used with the Mycite smartphone application and a web-based portal for healthcare providers.
The information in this article will focus on the standard forms of Abilify.
FDA-Approved Uses
The FDA-approved uses for this drug vary based on your age and the form of Abilify you use.
The Abilify oral tablets and solution and the tablets that dissolve in your mouth are approved to treat the following in adults:
Manic or mixed episodes associated with bipolar disorder
Major depressive disorder (used along with antidepressants)
These oral formulations are also approved to treat the following in children:
Schizophrenia in children ages 13 years and older
Manic or mixed episodes associated with bipolar disorder in children ages 10 years and older
Irritability due to autism in children ages 6 years and older
Tourette's disorder in children ages 6 years and older
The Abilify intramuscular injection is approved to treat agitation due to schizophrenia or bipolar manic episodes in adults.
Off-label Uses
Sometimes, healthcare providers may prescribe Abilify to treat conditions or at doses that differ from what the drug was initially approved for. This is called an off-label use.
Abilify has been used off-label to treat:
Drug-induced hyperprolactinemia (high prolactin levels caused by other antipsychotics)
How Abilify Works
Abilify is thought to work by regulating certain chemicals in your brain. These include serotonin and dopamine.
Serotonin helps to regulate your mood and feelings of happiness. Like serotonin, dopamine helps regulate your mood. It also affects movement and how you experience pleasure and pain.
Symptoms of certain mental health conditions, including depression and schizophrenia, are thought to be caused by an imbalance of serotonin or dopamine in your brain. Abilify helps to balance these chemicals.
How Long Does It Take for Abilify to Work?
How long it takes for Abilify to work depends on the form of Abilify you take or use. Abilify intramuscular injection typically works faster than the oral forms. However, the effects of oral Abilify last longer.
If you take Abilify oral tablets or solution or tablets that dissolve in your mouth, it takes about three to five hours for the medication to reach peak concentration in your bloodstream.
However, you may not feel the drug's full effects for treating schizophrenia, bipolar disorder, or depression until about two weeks after you start taking Abilify. This is because it takes about two weeks for Abilify levels to build up in your body and remain stable enough for the medication to work fully.
With Abilify intramuscular injection, the medication reaches peak levels in your bloodstream one to three hours after receiving an injection. It works to reduce agitation due to schizophrenia or manic episodes within two hours of receiving a dose.
The effects of oral Abilify last about one day, so these forms of the medication are typically taken once per day.
The effects of Abilify intramuscular injection only last a few hours. In some cases, healthcare providers may give another Abilify injection if agitation continues or returns two hours after the last dose.
Abilify Leaving the Body
Your body removes Abilify by breaking down the drug through certain proteins in your liver.
When you take a dose of Abilify, the active ingredient, aripiprazole, breaks down into a byproduct called dehydro-aripiprazole. Both parts of the drug are active in your body.
The time it takes for your body to get rid of half the amount of medication in your bloodstream is called a half-life. In general, it takes about four to five half-lives for your body to clear a drug completely.
Each drug has a different half-life, which may vary from person to person based on certain factors. These include:
Your age
How well your liver and kidneys work
How fast your liver proteins break down some drugs
With Abilify, both the active ingredient and its byproduct have a different half-life. The half-life of aripiprazole is about 75 hours, and for its byproduct, it's 94 hours.
This means it generally takes 12 to 15 days for aripiprazole to leave your body completely and 15 to 20 days to clear the byproduct dehydro-aripiprazole entirely.
One of the proteins that helps break down Abilify in your liver is called cytochrome P450 2D6 (CYP2D6). For some people, their CYP2D6 protein breaks down drugs slower than usual. In these cases, the half-life of Abilify is about 146 hours. So, it would take about 24 to 30 days to completely clear the drug.
Because of this, healthcare providers typically prescribe lower doses of Abilify for people with a slower-acting CYP2D6 protein.
Dosing Abilify
Your healthcare provider will prescribe a dosage of Abilify specific to your condition. Other factors can affect your dosage, including:
Your age
How fast your liver proteins beak down Abilify
The form of Abilify you use
Other medications you take
The following are dosing guidelines for schizophrenia and major depressive disorder recommended by the Abilify manufacturer. Be sure to take Abilify precisely as your healthcare provider recommends.
Condition | Recommended dosage for adults | Recommended dosage for children (13 years and older) |
Schizophrenia | 10 to 15 milligrams (mg) once per day | 10 mg once per day |
Major depressive disorder | 5 to 10 mg once per day | N/A |
The table above summarizes dosages for Abilify oral tablets, solution, and tablets that dissolve in your mouth.
Abilify intramuscular injection is approved to treat agitation due to schizophrenia or bipolar manic episodes. For this use, the recommended dose is 9.75 mg (1.3mL) injected into the muscle once. If additional doses are necessary, they should be spaced at least two hours apart.
Side Effects and Precautions
Like most medications, Abilify may cause side effects in some people.
Common Side Effects
The following are some of the more common side effects of Abilify:
Difficulty staying still
Sleepiness
Severe Side Effects
Although not common, Abilify may cause some severe side effects.
These include:
Movement problems, such as tardive dyskinesia
Long-Term Side Effects
Although most Abilify side effects are temporary or go away after you stop taking the medication, in rare cases, some side effects may last longer.
For example, tardive dyskinesia is a rare side effect of Abilify. It's more likely to happen after you've been taking the medication for a long time.
With tardive dyskinesia, you may have involuntary movements, such as lip smacking or excessive eye blinking.
This side effect may go away after you stop taking Abilify. However, in some cases, it may continue after you've stopped taking the medication.
Boxed Warnings
Abilify has the following serious warnings from the FDA. These are called boxed warnings:
Increased risk of death in adults ages 65 years or older with psychosis due to dementia
Increased risk of suicidal thoughts or actions in children and adults ages 24 years or younger
Keep in mind that this is not a complete list of side effects for Abilify. To learn more about the potential side effects of Abilify, talk with your pharmacist or another healthcare provider.
Safely Taking Abilify
Abilify is usually prescribed for long-term use if you and your healthcare provider decide it's safe and effective for you.
However, it's important to talk with your healthcare provider about your health conditions before you start taking Abilify.
These may include:
It's not known whether it's safe to take Abilify during pregnancy or while breastfeeding.
Before you start Abilify treatment, let your healthcare provider know if you're pregnant, breastfeeding, or planning either. They'll help you decide whether Abilify is safe for you to take.
Potential for Interactions
It's important to let your healthcare provider know all the medications you take before you start Abilify treatment.
Some medications may negatively interact with Abilify. They may affect how well Abilify works or increase your risk of side effects.
Drugs that may interact with Abilify include:
Certain antibiotics, such as clarithromycin
Certain antidepressants, such as Prozac (fluoxetine)
Benzodiazepines, such as Ativan (lorazepam)
Abilify can also interact with grapefruit or grapefruit juice. Consuming these foods may cause Abilify to build up in your body, increasing your risk of side effects.
Drinking alcohol while taking Abilify can increase your risk of side effects, such as sleepiness and nausea.
If you drink alcohol, talk with your healthcare provider to learn how much is safe to consume while taking Abilify.
Review of Efficacy
Several studies investigated the efficacy of Abilify compared with placebo (no drug) before the medication was approved by the FDA.
These studies showed that Abilify was more effective than placebo in relieving symptoms of schizophrenia in adults and children.
Abilify was also significantly better than placebo in reducing symptoms of manic episodes due to bipolar disorder in children and adults.
In studies of people taking Abilify to treat major depressive disorder along with another medication for depression, Abilify was more effective than placebo in reducing symptoms of depression.
Diagnosing Mood Disorders
Mood disorders are diagnosed by clinical examination by a healthcare provider or mental health professional applying standard diagnostic criteria.
Diagnosing Schizophrenia
Symptoms of schizophrenia typically start between the ages of 16 and 30.
They can include:
Inability to express emotions
Disorganized thinking and speech
To diagnose schizophrenia, a psychiatrist typically conducts an examination. They first check to see whether symptoms are due to another mental health condition or substance use disorder.
Before a psychiatrist diagnoses schizophrenia, symptoms must have been present for at least six months.
Diagnosing Major Depressive Disorder
Symptoms of depression can include:
Changes in appetite
Trouble sleeping or sleeping too much
Having a depressed mood or feeling sad
Loss of energy
Feelings of worthlessness
Thoughts of dying or suicide
To diagnose depression, a healthcare provider will examine you to determine whether your symptoms are due to a different health condition.
They may make a diagnosis of major depressive disorder if your symptoms last at least two weeks and are different from your usual level of functioning.
Summary
Abilify (aripiprazole) is an atypical antipsychotic FDA-approved to treat symptoms of schizophrenia and bipolar disorder in adults and children ages 13 years and older. Abilify is also used to treat major depressive disorder in adults and certain symptoms related to Tourette's disorder and autism in children ages 6 years and older.
Abilify comes as an orally administered tablet and solution, a tablet that dissolves in your mouth, and an intramuscular injection.
The oral forms of Abilify typically take longer to start working, but their effects last longer than the intramuscular injection. It takes about two weeks to feel the full effects of Abilify oral forms. The effects of one dose last a full day.
Abilify intramuscular injection starts working within two hours of receiving a dose. However, the effects only last a few hours.
Abilify is approved for use in children ages 6 years and older and adults of all ages. However, it's essential to keep in mind that this drug carries the following serious warnings from the FDA:
Risk of death in older adults with psychosis due to dementia
Risk of suicidal thoughts and behaviors in children and younger adults
Before starting Abilify treatment, it's important to talk with your healthcare provider about your health history and all the medications you take. Sharing this information with them will help determine if Abilify is safe for you.
Frequently Asked Questions
How should Abilify be stored?
Abilify tablets and oral solution should be stored at room temperature (77 degrees F). If necessary, you may store Abilify at temperatures between 59 and 86 degrees F for limited periods.
Abilify injection is given by a healthcare provider. It will likely be stored at the hospital or other healthcare facility where you receive your dose.
Like all medications, Abilify should be kept out of the sight and reach of children and pets.
Can I take Abilify with me while traveling abroad?
Yes, with some preparation, you can take Abilify with you while traveling abroad. It's a good idea to keep your prescription medications in their original containers while you travel. In some cases, you may need to also have a copy of your prescription on hand.
If you're traveling by air with Abilify oral solution, be sure to check with your airline beforehand for instructions on traveling with liquid prescription medications.
Read the original article on Verywell Health.
