Aripiprazole: characteristics and side effects of this drug

April 24, 2024

The suffering of different mental disorders on the part of the population has meant that, throughout history, different mechanisms and measures have been sought to be applied in order to treat such affectations. Even in ancestral cultures and prehistory, rituals such as trepanation have been carried out for this purpose. But over the years, different methodologies have been refined that are highly effective in the treatment of these disorders.

Among them we find the synthesis of substances that eliminate or reduce the symptoms: the psychotropic drugs. With regard to schizophrenia, it is now considered that pharmacological treatment is of great importance for the maintenance and stabilization of patients. Y Among the multiple existing psychotropic drugs we can find aripiprazole , which we are going to talk about in this article.

Related article: "Types of psychotropic drugs: uses and side effects"

Aripiprazole: what is it?

Aripiprazole is a psychopharmaceutical classified as an antipsychotic or neuroleptic, drugs specially designed to produce a positive effect in the reduction and elimination of the symptoms of schizophrenia and psychotic disorders , such as delusions and hallucinations and psychomotor agitation.

Within antipsychotics is classified as atypical , because its creation is based on the attempt to elaborate effective drugs in the treatment of these symptoms without producing the level of side effects that the typical or classic ones have, as well as increasing the effectiveness in the treatment of a type of symptomatology, negative (those symptoms that reduce the functionality of the skills present in the patient, such as the impoverishment of thought and apathy), that the typical antipsychotics do not treat or can even harm.

And in this task it is especially efficient, contributing to fight with both positive and negative symptoms. In addition to this, it has the advantage of having a possible administration in the form of intramuscular injection in depot format (slow release) at monthly level, not being necessary in these cases taking the drug orally continuously.

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Mechanism of action

Aripiprazole is, as we have said, an atypical antipsychotic. As with most of this type of neuroleptic, its effects are due to its action on two systems of neurotransmission: that of dopamine and serotonin . However, its mechanism of action is somewhat different from the rest of atypical in what refers to dopamine.

And is that although most antipsychotics, both typical and atypical, usually work by blocking the dopamine D2 receptors in the brain, this is not the case of aripiprazole. This drug is in fact a partial agonist of the D2 receptors, favoring in principle its presence in the brain . This in principle would allow to increase the positive psychotic symptoms, but nevertheless the certain thing is that it reduces them.

This reduction is explained by the action on serotonin. The rest of the atypicals diminish the cerebral serotonin in such a way that it stops inhibiting the dopamine in the areas that do not require a reduction of this, so that the blocking action that they generally produce has an effect in the mesolimbic pathway (the positive symptoms as hallucinations are produced by an excess in this pathway) but in the cortex said blocking effect is reduced and compensated by the inhibition of an inhibitor (serotonin).

In the case of aripiprazole this effect occurs in part in some types of serotonin receptors, being blocked by the drug, while on the other hand it stimulates its synthesis as a partial agonist of the 5-HT1a receptors. This contributes to a decrease in the level of dopamine in some areas, while in general it increases in others.

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Indications

The main indication for aripiprazole is the treatment of schizophrenia and other psychotic disorders. In this sense helps reduce or eliminate positive symptoms , be it in the form of hallucinations, agitation or alterations of behavior, at the same time that it has positive effects on the negative (apathy, poverty of thought and affective flattening among others). It is also used to keep stable those who suffer from these disorders, from fifteen years of age.

It has also been used effectively in the treatment of manic episodes in the context of a bipolar disorder, from the thirteen years of age. Not only in the treatment of acute crises, but also in the prevention of new episodes. But nevertheless, in some subjects it is possible that the consumption of this drug triggers manic episodes .

In addition to the above indications, this drug is also sometimes used in the treatment of problems such as Tourette's disorder or autism, usually to control its clinical manifestations.

Side effects

Although very useful in many disorders, aripiprazole is a psychotropic drug that can lead to numerous side effects of varying severity.

Among the most frequent we can find the presence of drowsiness and fatigue, weight gain, headache, increased appetite, nervousness , hypersalivation, muscle pain, gastrointestinal disorders, diarrhea or constipation and balance problems. Insomnia and anxiety are common. Other more serious would include altered consciousness, hyperglycemia, respiratory distress, muscle stiffness, visual disturbances, arrhythmias and dyskinesias, as well as suicidal thoughts. Unlike other antipsychotics, the presence of sexual or motor alterations are not frequent.

In addition, it has been observed in recent years how the administration of this drug has been associated in some cases (although it is not common) with a increased impulsivity, pathological gambling, hyperphagia, increased libido and the search for sexual relationships and the existence of compulsive behaviors such as shopping. In short, it has been associated in some people with the existence of loss of control of impulses, something that can have various consequences for the person in question.

Contraindications and risks

Aripiprazole is a very potent drug that can generate diverse effects in the organism, being able to suppose a considerable risk and being contraindicated in different types of population.

Among those who should not consume this drug we can find those people with allergies to it or to any of its components. This drug is also highly contraindicated by people suffering from dementia, increasing in these cases the risk of death of the subject. The presence of cardiopathies or cardiovascular and cerebrovascular diseases They also make this drug somewhat contraindicated.

People with diabetes should avoid this drug, since its consumption can raise sugar levels greatly and lead to dangerous hyperglycemia. Those with liver or kidney disease should not use aripiprazole if their condition is severe, or at least they should rate the doses consumed with the doctor. Also, people with epilepsy are at risk of severe seizures if they take this drug. Another of its contraindications is in pregnant women and breastfeeding, since it increases the risk to the fetus and the drug is transmitted by placenta and by breast milk.

Aripiprazole can interact with different medications, an interaction that can be harmful. Among these drugs are some of those used in the treatment of HIV, as well as antidepressants, antihypertensive drugs and some anticonvulsants. Nor should it be consumed together with alcohol or other drugs .

With regard to the loss of control of impulses, those persons who already suffer a disorder of this type, subjects with substance dependence (whether or not they are already uninhabited), bipolarity (despite being a possible drug to be used for treatment) and obsessive-compulsive disorder.