Antipsychotic  ·  Third-Generation Antipsychotic

Aripiprazole

Also known as: Abilify (global), Arip, Arize, Arlet, Arpizol, Aripi

A newer-generation antipsychotic with the least effect on weight and metabolism of any second or third-generation medicine, added to the WHO Essential Medicines List in 2023.

ATC CodeN05AX12
Kenya EML 2023Listed
Level of UseLevel 4 to 6
This is health education, not medical advice. Never start, stop, or change a medication without speaking to a qualified healthcare professional first.
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Prescription Only Medicine

Available on prescription.

Which conditions is Aripiprazole used for?

What is Aripiprazole?

Aripiprazole is a third-generation antipsychotic with a mechanism genuinely different from all previous antipsychotics. Rather than simply blocking dopamine receptors, it partially activates them, acting as a stabiliser rather than a pure blocker.

It was added to the WHO Model Essential Medicines List in 2023 in recognition of its clinical value, and is also listed in Kenya's Essential Medicines List 2023.

Its most significant advantage is minimal effect on weight and metabolic markers, making it an important option where metabolic health is already a concern.

What does it do in the brain?

Aripiprazole partially activates dopamine receptors where dopamine activity is too low, and partially blocks them where it is too high. This stabilising effect explains why it can treat psychotic symptoms with lower movement side effects. It also acts on serotonin receptors in a way that may contribute to antidepressant properties.

How is it available?

Tablet
5 mg to 30 mg
Taken by mouth
Available
Orally disintegrating tablet
10 mg, 15 mg
Dissolves on the tongue
Limited availability

Where is it available in Africa and what is it called?

Names and availability vary by country. Always confirm with a local pharmacist or healthcare provider.
CountryCommon Brand Name(s)Notes
KenyaAbilify, Arip, Arize, genericOn KEML 2023. Available at public and private facilities.
South AfricaAbilify, Arpizol, genericOn South Africa EML. Widely available.
NigeriaAbilify, Aripi, genericAvailable at teaching hospitals and urban private pharmacies.
GhanaAbilify, genericAvailable at teaching hospitals and specialist facilities.
UgandaGeneric aripiprazoleAvailable at national referral hospitals.
TanzaniaGeneric aripiprazoleAvailable at regional referral hospitals.
EthiopiaGeneric aripiprazoleAvailable at major private pharmacies in Addis Ababa.

What might you feel while taking it?

These are the most commonly reported effects. Not everyone experiences them, and many settle within the first few weeks.

  • Akathisia: an inner sense of restlessness and urge to keep moving. Tell your doctor if you experience this.
  • Insomnia or feeling more energised than usual, particularly early in treatment
  • Nausea and headache in the first weeks
  • Dizziness
  • Minimal weight gain, which is a genuine advantage over most other antipsychotics
Go to a doctor or emergency room straight away if you notice any of the following.
  • Severe akathisia can be very distressing. It is treatable, but you must tell your doctor.
  • New or unusual compulsive behaviours such as gambling, compulsive spending, or hypersexuality
  • Neuroleptic Malignant Syndrome, rare but possible with any antipsychotic

Important risks you should understand before taking this medicine

Read this section carefully. These are real risks associated with this medicine that every person taking it should be aware of.
  • Akathisia, an intensely uncomfortable inner restlessness and urge to keep moving, is more common with aripiprazole than with most other atypical antipsychotics. It can be severe enough to cause significant distress and treatment discontinuation. Tell your doctor at the first sign.
  • In some people taking aripiprazole, impulse control problems have been reported, including unusual gambling behaviour, compulsive shopping, or sexual behaviour that is out of character. Tell your doctor if you notice changes in this area.
  • Because aripiprazole has activating properties, it can worsen insomnia or agitation when starting treatment, before the full antipsychotic benefit is felt. This is a real early challenge that should be anticipated and planned for.
  • As with all antipsychotics, elderly patients with dementia have an increased risk of stroke and death on aripiprazole.
  • Stopping aripiprazole suddenly causes rapid return of psychotic or manic symptoms. Never stop without medical supervision.

Important warnings before starting

Tell your doctor about all your medical conditions, allergies, and other medicines before starting Aripiprazole.
  • Known allergy to aripiprazole

Situations that need extra attention

  • If you experience internal restlessness or an urge to keep moving, tell your doctor
  • Tell your doctor about any impulse control or compulsive behaviour that is new since starting the medicine
  • Elderly patients with dementia carry higher risk on any antipsychotic
Pregnancy
Speak to your doctor if you are pregnant or planning a pregnancy. A careful risk-benefit assessment with a specialist is important.
Breastfeeding
Present in breast milk. Specialist guidance required.

Medicines and substances that can interact with it

Always tell your doctor and pharmacist about every medicine, supplement, and herbal remedy you take, including those bought without a prescription.
  • Carbamazepine and rifampicin: Substantially reduce aripiprazole levels. Your doctor may need to adjust the dose.
  • Certain antidepressants affecting the same liver enzymes: Can raise aripiprazole levels, increasing side effects.
  • Alcohol and sedating medicines: Amplify sedation.

What your doctor will monitor

  • Akathisia assessment at every appointment, particularly in the first months
  • Impulse control review at each appointment
  • Basic metabolic panel at initiation and annually
  • Movement assessment every 6 to 12 months

What happens if you stop taking it?

Do not stop aripiprazole suddenly. Gradual reduction under your doctor's guidance is needed.

What you should know about this medicine in Kenya

Aripiprazole's minimal weight gain and metabolic impact gives Kenyan patients an important option, particularly for younger people sensitive to long-term metabolic consequences.

Its addition to the WHO EML 2023 and the KEML 2023 marks a recognition that treatment options should include medicines with a genuinely different safety profile.

Generic aripiprazole has become increasingly available in Kenya, improving cost accessibility.

References

  1. Ministry of Health, Kenya. (2023). Kenya Essential Medicines List 2023. Nairobi: Ministry of Health.
  2. Ministry of Health, Kenya. (2023). Kenya National Medicines Formulary, 1st Edition. Nairobi: Ministry of Health.
  3. Leucht, S., et al. (2013). Comparative efficacy and tolerability of 15 antipsychotic drugs. The Lancet, 382(9896), 951-962.
  4. World Health Organization. (2023). Model List of Essential Medicines, 23rd Edition. Geneva: WHO.