Aripiprazole: what it treats, how to take it, side effects
Last updated September 3, 2026.
Aripiprazole is an atypical antipsychotic - it changes the activity of certain natural substances in the brain. You may know it as Abilify. It has the widest job description in its class, and one genuinely unusual side effect everyone should hear about: it can turn up the volume on urges.
What does it treat?
Schizophrenia, bipolar disorder, major depressive disorder alongside an antidepressant, the irritability that comes with autistic disorder, and Tourette's disorder. It controls symptoms; it does not cure the condition, and the full benefit can take 2 weeks or longer.
How do you take it?
Once a day, with or without food, same time every day. Tablets are swallowed whole; the solution needs the measuring device it comes with, never a kitchen spoon; the dissolving tablet and the tongue film come out of their foil with dry hands, immediately before use. Your doctor starts low and adjusts by how you respond. Keep taking it when you feel well, and never stop without your doctor. Missed dose: take it when you remember unless the next one is close; never double up.
Side effects to know
- Common: headache, nervousness or restlessness, dizziness or unsteadiness, heartburn, constipation or diarrhea, weight gain and appetite changes, extra saliva, joint or limb pain, and tiredness.
- Serious - call your doctor immediately: uncontrollable movements of the face, tongue, or other body parts; fever with stiff muscles, sweating, confusion, or a fast or irregular heartbeat (neuroleptic malignant syndrome); seizures; tightening of the neck or throat or trouble swallowing; falls and coordination problems; and rash, hives, facial swelling, or trouble breathing.
Who should not take it?
The two boxed warnings first: older adults with dementia have an increased risk of death and stroke on antipsychotics, and aripiprazole is not approved for dementia-related behavior problems. Second, children, teenagers, and young adults treated for depression have an increased risk of suicidal thinking, especially at the start and around dose changes - family should know the signs. Then the unusual one: aripiprazole can cause intense compulsive urges - gambling, shopping, eating, sexual behavior - that feel unlike you. Tell your family this can happen, because they may spot it before you do, and call your doctor if urges show up. Flag diabetes or family diabetes, heart problems, stroke history, seizures, low white blood cell counts, high cholesterol, and swallowing difficulties. St. John's wort interacts; grapefruit needs a conversation; the dissolving tablets contain phenylalanine (PKU); the solution contains sugar (diabetes). Alcohol adds to the drowsiness: do not drink while taking it. Overheating is easier on this medicine. Taken in the last months of pregnancy it can affect newborns - if you become pregnant, call your doctor.
When is it an emergency?
Fever with stiff muscles and confusion, a seizure, or trouble breathing or swallowing is a 911 call. Any thought of harming or killing yourself - new, worsening, or around a dose change - means calling your doctor immediately, and the 988 Suicide and Crisis Lifeline (call or text 988) is there anytime. For an overdose, call Poison Control at 1-800-222-1222. Pymander's escalation routing is built and tested specifically for this class of decision; see the safety architecture working paper.
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Common questions
Why would a mental health medication make me want to gamble?
A documented effect, straight from MedlinePlus: some people on aripiprazole develop gambling problems or other intense, compulsive urges - increased sexual behavior, excessive shopping, binge eating - that are unusual for them, and the urge goes away when the dose is reduced or the drug stopped. The catch is that you may not notice it happening. Tell your family about this risk at the start so they can call the doctor even when you do not see the problem yourself.
Why does aripiprazole carry boxed warnings?
Two, from the label. Older adults with dementia have an increased risk of death and stroke on antipsychotics, and aripiprazole is not approved for dementia-related behavior problems. And children, teenagers, and young adults treated for depression have an increased risk of suicidal thinking - most at the start and around dose changes. Family knowing the warning signs is part of the prescription.
Why does my doctor say aripiprazole takes weeks to work?
Because brain chemistry adjusts slowly. MedlinePlus says it may take 2 weeks or longer before you feel the full benefit - and that you should keep taking it even if you feel well, since feeling well is the medicine working, not the condition being cured. Stopping is always a conversation with your prescriber, never a solo call.
Can I drink alcohol while taking aripiprazole?
No - MedlinePlus says it directly: alcohol can add to the drowsiness this medication causes, so do not drink while taking it. The drug can already blur balance and reaction time, and alcohol stacks on top of both.
Is St. John's wort really a problem with aripiprazole?
Yes - it is the one herbal product MedlinePlus names for aripiprazole. It changes how the body processes the medicine. Tell your doctor and pharmacist before starting aripiprazole if you take it, and do not start it during treatment without discussing first.
What happens if I miss a dose of aripiprazole?
Take it as soon as you remember, unless it is almost time for the next one - then skip it and never double up. Once-daily medicines forgive a single slip; the pattern that matters is steady daily levels over weeks. A fixed morning or evening anchor does the work.