Indications
Ariprex serves as a treatment option for various conditions including:
- Schizophrenia
- Bipolar disorder
- Adjunctive treatment of major depressive disorder
- Irritability associated with autistic disorder
- Agitation linked with schizophrenia or bipolar mania
Pharmacology
Aripiprazole, classified as an atypical antipsychotic, exhibits efficacy by engaging in partial agonist activity at Dopamine D2 and Serotonin 5-HT 1A receptors while displaying antagonist activity at Serotonin 5-HT 2A receptors. This multifaceted mechanism contributes to the management of schizophrenia, bipolar disorder, major depressive disorder, irritability in autistic disorder, and agitation associated with schizophrenia or bipolar disorder.
Dosage
For effective management:
- Schizophrenia in adults typically starts with an initial dose of 10-15 mg/day, with a maximum dosage of 30 mg/day.
- Adolescents aged 13-17 years with schizophrenia may commence with 2 mg/day, with gradual adjustments up to 30 mg/day.
- Bipolar mania in adults as monotherapy or adjunctive therapy with lithium or valproate may range from 10-15 mg/day initially, with a maximum dose of 30 mg/day.
- Pediatric patients aged 10-17 years with bipolar mania may start with 2 mg/day, with a maximum dosage of 30 mg/day.
- As an adjunct to antidepressants for major depressive disorder, adults may begin with 2-5 mg/day, with adjustments up to 15 mg/day.
- Pediatric patients aged 6-17 years with irritability associated with autistic disorder may start with 2 mg/day, with a maximum dose of 15 mg/day.
Administration
Ariprex is typically administered orally once daily, irrespective of meals. For intramuscular injections, maintain at least a 2-hour interval between doses, with a maximum daily dose of 30 mg.
Interactions
Exercise caution when combining Ariprex with other centrally acting drugs or alcohol. Carbamazepine may enhance Ariprex clearance, while ketoconazole, quinidine, fluoxetine, or paroxetine may inhibit Ariprex elimination, leading to increased blood levels.
Contraindications
Avoid Ariprex if there is known hypersensitivity to Aripiprazole.
Side Effects
Potential side effects may include vomiting, nausea, akathisia, extrapyramidal disorder, somnolence, sedation, dizziness, insomnia, tremor, restlessness, fatigue, blurred vision, salivary hypersecretion, constipation, pyrexia, drooling, and decreased appetite.
Pregnancy & Lactation
Aripiprazole falls under pregnancy category C and should be avoided during pregnancy. It is advisable that women receiving Aripiprazole should refrain from breastfeeding.
Precautions & Warnings
Exercise caution in the following scenarios:
- Elderly patients with dementia-related psychosis may experience an increased incidence of cerebrovascular adverse events.
- There’s an elevated risk of suicidality in children, adolescents, young adults, and major depressive disorder patients.
- Discontinue if tardive dyskinesia is clinically appropriate.
- Monitor for metabolic changes, orthostatic hypotension, seizures/convulsions, and advise caution when operating machinery.
Overdose Effects
Ariprex overdose, even at doses up to 1080 mg, has not resulted in fatalities. Symptoms may include nausea, vomiting, asthenia, diarrhea, and somnolence.
Therapeutic Class
Ariprex belongs to the class of atypical neuroleptic drugs.
Storage Conditions
Store Ariprex below 30°C, away from light and moisture. Ensure it’s out of reach of children.
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