Aripiprazole side effects

Side Effect Clozapine Risperidone Olanzapine Quetiapine Ziprasidone Aripiprazole Haloperidol... 

Current or past anti-cholinergic side effects Risperidone, quetiapine, aripiprazole ziprasidone Olanzapine (low dose)... 

Extrapyramidal side-effects generally appear with blockade of dopamine D2 receptors in excess of 80%, whereas clinical efficacy in treating psychosis is associated with 60-70% D2 receptor blockade [12]. Recently, a partial agonist for the D2 receptor known as aripiprazole has been developed, which results in approximately 70% antagonism/30% agonism at the D2 receptor. It is an effective antipsychotic, has low risk for extrapyramidal symptoms, and does not cause elevated levels of prolactin as do the full antagonists at D2 receptors. 

Quetiapine (Seroquel). Another atypical antipsychotic, quetiapine has also been approved by the FDA for the treatment of acute mania. It is usually administered twice daily at doses of 150-750mg/day. Like its counterparts, quetiapine is a well-tolerated medication. Its common side effects are drowsiness, dizziness, and headache. It causes less weight gain than olanzapine or clozapine but more than ziprasidone or aripiprazole. Quetiapine also does not cause agranulocytosis nor does it increase the risk of seizures. It can occasionally cause mild changes in liver function tests, but these usually return to normal even if the patient continues taking quetiapine. 

Aripiprazole (Abilify). Aripiprazole is indicated for the treatment of acute mania and for maintenance therapy. It is dosed at 5-30mg/day. Aripiprazole is well tolerated with the most common side effects being headache, agitation, anxiety, insomnia, and nausea. 

Daily doses of aripiprazole range from 5 to 30 mg. Aripiprazole is very well tolerated. Common side effects include headache, insomnia, nausea, dizziness, and constipation. 

We prefer low doses of atypical antipsychotics as a first-line treatment. In this way, the threat of extrapyramidal symptoms is largely avoided without having to use a second anticholinergic medication to offset antipsychotic side effects. Risperidone 0.25-0.5mg/day, olanzapine 2.5mg/day, quetiapine 25mg/day, ziprasidone 20mg/day, or aripiprazole 2.5-5mg/day are reasonable starting doses. The typically higher doses used to treat schizophrenia are usually not necessary. 

Antipsychotics in a few small studies have been shown to be helpful. To date this research is limited to typical antipsychotics. Nevertheless, the excellent track record of atypical antipsychotics in treating schizophrenia and the lower burden of side effects lead us to recommend atypical antipsychotics as a first-line treatment for STPD as well. Low doses of risperidone, olanzapine, quetiapine, ziprasidone, or aripiprazole are all reasonable options. If no therapeutic effect is observed, doses should be increased. 

Aripiprazole is an atypical antipsychotic agent that is not associated with an impact on prolactin levels and is not associated with impotence as a side-effect. It may precipitate suicidal ideation as a side-effect. 

Rhabdomyolysis is the destruction of skeletal muscle tissues and may be associated with lipid-regulating drugs such as the fibrates and the statins. The risk of this side-effect is increased in patients with renal impairment and with hypothyroidism. Rhabdomyolysis may also occur with nicotinic acid, the antipsychotic aripiprazole, and the anaesthetic propofol. 

Atypical antipsychotics cause fewer EPS than do conventional antipsychotics. Clozapine and quetiapine are the least likely to cause EPS and are therefore recommended for treatment of psychosis in patients with Parkinson s disease. With the notable exception of risperidone, atypical antipsychotics cause substantially less hyperprolactinemia than do conventional antipsychotics. Weight gain is a side effect of all atypical antipsychotics except ziprasidone and aripiprazole. Concerns about cardiac conduction delay with ziprasidone therapy exist and warrant consideration in patients who have... 

The most common side effects associated with aripiprazole include headache, nausea, dyspepsia, agitation, anxiety, insomnia, somnolence, and akathisia. Dose-related adverse events include somnolence and akathisia. Early clinical experience indicates that akathisia may be avoided by starting the medication at doses lower than 10 mg and increasing the dose slowly. Aripiprazole is not associated with significant sedation, anticholinergic side effects, weight gain, or cardiovascular side effects (Petrie et al. 1997). 

Aripiprazole, olanzapine, quetiapine , risperidone, and ziprasidone are effective as monotherapy or as add-on therapy to lithium or valproate for acute mania. Prophylactic use of antipsychotics can he needed for some patients with recurrent mania or mixed states, hut the risks versus benefits must be weighed in view of long-term side effects (e.g., obesity, type 2 diabetes, hyperlipidemia, hyperprolactinemia, cardiac disease, and tardive dyskinesia). 

ARIPIPRAZOLE, HALOPERIDOL, CLOZAPINE, PIMOZIDE, RISPERIDONE, SERTINDOLE PROTEASE INHIBITORS Possibly T levels of antipsychotic Inhibition of CYP3A4- and/or CYP2D6-mediated metabolism Avoid co-administration of clozapine with ritonavir, and pimozide or sertindole with protease inhibitors. Use other antipsychotics with caution as 1 dose may be required with risperidone, watch closely for extrapyramidal side-effects and neuroepileptic malignant syndrome... 

No placebo-controUed trials are currently available evaluating quetiapine, ziprasidone, or aripiprazole in psychosis of dementia. An open-label study suggests possible effect and good tolerability with quetiapine. For patients who respond inadequately, have elevated cardiovascular risk, or who have unacceptable side effects... 

Quetiapine has sedative effects and may cause weight gain, bnt it causes minimal extrapyramidal side effects or prolactin elevations. Ziprasidone canses few extrapyramidal side effects, does not significantly increase prolactin levels, and has a lower risk of causing weight gain. Aripiprazole has low extrapyramidal side effects (except for initial akathisia), minimal effect on prolactin levels, and is considered to be weight neutral. 

---