Abilify

What is Abilify?

Abilify is a prescription-only medication widely used to manage psychiatric conditions such as schizophrenia, bipolar I disorder, and as an adjunctive treatment for major depressive disorder. It is also utilised in specific paediatric cases to manage irritability associated with autistic disorder and Tourette’s disorder.

Belonging to a class of drugs known as atypical antipsychotics, it differs from older medications by functioning as a dopamine system stabiliser. Rather than purely blocking dopamine receptors, aripiprazole acts as a partial agonist at specific dopamine and serotonin receptors, and as an antagonist at others. This unique chemical action effectively balances neurotransmitter activity to reduce symptoms while minimising certain side effects like severe sedation.

Generic Names:

• Aripiprazole: The primary active pharmaceutical ingredient, widely recognised and prescribed globally.

Global Brand Names:

Aripiprazole is distributed under several brand names depending on the manufacturer and the local market.

• Abilify (安立復): The original brand developed by Otsuka Pharmaceutical, widely available in Hong Kong in tablet, orodispersible, and injectable forms.
• Aripiprazole Sandoz: A registered generic version of the medication available in the Hong Kong market.
• Aripiprazole Teva: Another registered generic alternative distributed in Hong Kong.

These names all refer to the same medication. It's important to note that while the active ingredient is the same, different countries may have different regulations and available medication formulations.

What is Abilify used for?

Abilify is used to relieve:

• Acute episodes and maintenance of schizophrenia
• Manic or mixed episodes in bipolar I disorder
• Symptoms of major depressive disorder (as an add-on treatment)
• Irritability and aggression in autistic disorder (paediatric patients)
• Tics associated with Tourette's disorder

How do you use Abilify?

Availability:

• Tablets
• Orodispersible (dissolving) tablets
• Oral solution
• Intramuscular or intravenous injection

Dosage Information:

• Adults: Typically started at 10 to 15 mg once daily for schizophrenia or bipolar mania, with a maximum dose of 30 mg. For depression, started at 2 to 5 mg daily.
• Infants/Children: Lower starting doses (e.g., 2 mg) with gradual titration based on weight and the specific condition being treated.
• Elderly: Generally started at lower doses; strictly monitored due to increased safety risks.

Suitability:

• Adults: Yes, for indicated psychiatric conditions.
• Children and Adolescents: Yes, but only for specific indications like Tourette's or autism irritability under specialist supervision.
• Elderly: No, contraindicated for dementia-related psychosis.

Who cannot take Abilify?

Allergies and unsuitability:

• Rare, but possible severe allergic reactions to aripiprazole.

Conditions where the drug should not be used:

• Dementia-related psychosis in elderly patients
• Known allergy to aripiprazole or any of its excipients

Common side effects of Abilify include a distinct sense of internal restlessness (akathisia), headaches, nausea, vomiting, dizziness, constipation, and blurred vision. Because it is a dopamine system stabiliser, it generally carries a lower risk of severe weight gain and sedation compared to older antipsychotic medications, though metabolic changes are still possible.

Severe adverse reactions require immediate medical attention. These include Neuroleptic Malignant Syndrome (a rare condition causing high fever and muscle rigidity), Tardive Dyskinesia (uncontrollable muscle movements), seizures, orthostatic hypotension (a sudden blood pressure drop when standing), and unusual impulse control issues such as pathological gambling or binge eating.

• Do not use in elderly patients with dementia-related psychosis due to an increased risk of death.
• Monitor adolescents and young adults closely for increased suicidal thoughts or behaviours.
• Report any unusual urges, such as compulsive gambling or binge eating, to a medical professional immediately.
• Avoid alcohol to reduce the risk of severe sedation and cognitive impairment.
• Check with a doctor before starting any CYP3A4 or CYP2D6 inhibitors (like ketoconazole or fluoxetine), as these can dangerously increase Abilify levels in the blood.
• Check with a doctor before taking CYP3A4 inducers (like carbamazepine), as they may decrease the medication's effectiveness.

Storage information:

• Keep at room temperature between 15°C and 30°C.
• Store in a dry place away from direct light and moisture.
• Keep strictly out of reach of children.

Handling instructions:

• Swallow regular tablets whole with a glass of water, with or without food.
• Allow orodispersible tablets (Discmelt) to dissolve completely on the tongue without chewing.
• Use the provided measuring syringe or cup if taking the liquid oral solution to ensure an accurate dose.

Where is Abilify available in Hong Kong?

In Hong Kong, Abilify (aripiprazole) is classified as a Prescription Only Medicine. This means you must present a valid doctor's prescription to legally purchase it.

It can be obtained at registered pharmacy dispensaries that display the "Rx" logo, as well as through hospital and clinic pharmacies, under the direct supervision of a registered pharmacist.