Abilify make you sleepy

Aripiprazole Side Effects: Common, Severe, and More

Written by Keri Wiginton

Aripiprazole is an atypical or second-generation antipsychotic (SGA). It balances out your dopamine and serotonin levels. These are chemicals in your brain that affect how you think, feel, and act. Your thoughts may become clearer on this drug. You may stop hearing or seeing things that aren’t there. Your mood and motivation may get better.

Oral forms of the drug can also treat Tourette’s syndrome and symptoms of bipolar 1 disorder. Aripiprazole may help calm irritability in children and teens with autism. Your doctor may use it with other medicine to treat depression. You can get a shot of aripiprazole to treat agitation with schizophrenia or bipolar mania.

Aripiprazole can help your mind become more stable. But like any drug, it can cause unwanted side effects. Some are mild, but others can be serious. Talk to your doctor about what can happen if you or your child take this medicine.

Muscle Movement Problems

Restlessness. In clinical trials, about 8% of adults with schizophrenia reported akathisia. That’s a movement disorder that makes it hard to stay still. You may feel like you need to do something with your legs. You may want to pace or rock back and forth. It feels different than agitation or anxiety.

Extrapyramidal symptoms (EPS). If you’re younger than 20, you’re more likely to have muscles that move or twitch on their own. A review of 41 studies showed about 17% of young people on aripiprazole get EPS.

Symptoms of EPS include:

Repeated muscle contractions (dystonia)
Urge to move around (akathisia)
Body parts that shake (tremor)
Inability to bend (parkinsonism)

Tardive dyskinesia. This is a disorder where you can’t control the muscles in your tongue, mouth, face, and upper body. It can happen after you use antipsychotics for a long time. You’re more likely to get it if you have other medical or movement problems. But your chances may be lower on aripiprazole than older antipsychotics and some other SGAs. Tardive dyskinesia may stop once you quit your medicine. But sometimes it doesn't go away.

Metabolic Changes and Weight Gain

Atypical antipsychotics may boost your appetite or change how your body uses energy. This may lead to weight gain. Sometimes, these drugs can raise your blood sugar or cholesterol levels. That can make it more likely that you’ll have diabetes and heart disease.

But when compared to similar drugs, aripiprazole may lead to less weight gain and problems with your metabolism.

Children on SGAs are more likely to gain weight than adults, especially if they have schizophrenia or autism. But adolescents who take aripiprazole may gain less weight than kids on other antipsychotics.

Your doctor may want to keep an eye on your or your child’s weight. They may want to watch your glucose and cholesterol levels, too. In the meantime, make sure you eat a balanced diet and get plenty of exercise.

Desire to Sleep

Aripiprazole can make you tired. Somnolence, or a strong urge to sleep, is more common in children. The effects may be higher with bigger doses. But aripiprazole may cause less somnolence than similar drugs. It may go away with time.

Compulsive Behavior

It’s rare, but you may get an urge to gamble that you can’t resist. Less often, you may feel the need to have sex, shop, or eat in a way you can’t control. If your loved one acts like this, you may need to tell them. They may not know it’s not normal.

These urges usually go away when your doctor lowers your dosage or stops the medicine. But always talk to your doctor before you quit aripiprazole.

Neuroleptic Malignant Syndrome (NMS)

Rarely, this drug can cause a possibly fatal set of symptoms. NMS can affect your heart, muscles, and kidneys. You may also get:

A high fever
Stiff muscles
A change in your mental state
Irregular heartbeat or blood pressure
High heart rate
A lot of sweating

If you have any of these symptoms, check with your doctor right away. They’ll want to rule out other medical conditions first. If your medicine is the problem, you’ll stop taking aripiprazole right away. You’ll get treatment for your other symptoms.

Other Common Side Effects

In clinical trials, at least 10% of all adults (including those without schizophrenia) also had:

Nausea
Throwing up
Constipation
Headache
Dizziness
Anxiety
Insomnia

At least 10% of all children and young adults (including those without schizophrenia) also had:

Headache
Tiredness
Increased hunger

Insomnia
Nausea
Symptoms of the common cold

Less Common Side Effects

Some people may have drooling or get blurry vision, dry mouth, or a rash.

Serious Side Effects

In elderly people. Aripiprazole should not be used to treat dementia-related psychosis in older people. It may make their chances of stroke and death greater. The drug may make elderly people sleepy and lightheaded. They may not be able to swallow easily. This may raise their chances of injuries from falls or choking.

In young people. Antidepressants may raise the chances of suicidal thoughts in people younger than 24. If you care for a child or teenager on antidepressants, watch them closely for changes in their behavior. This is even more important during the first few months of treatment or if their dose changes. If you get worried, talk to your doctor.

After You Start Aripiprazole

Don’t drink alcohol or use illegal drugs when you take aripiprazole. Your medicine may not work as well if you do. You may also have worse side effects, like sleepiness.

Don’t operate machines or drive until you know how you’ll react to aripiprazole. Since it makes you drowsy, you may be more likely to have an accident. You may fall and hurt yourself if you’re tired.

You should tell your doctor if you exercise a lot or if you’re going to be somewhere that’s hot. That’s because the medicine may make it harder for your body to cool off. You should make sure to drink enough water.

What Else You Should Know

Your side effects may go away with time. But tell your doctor if you have any symptoms that you can’t control. They’ll help you figure out if you need to lower your dose or quit taking the drug.

Even if you feel better, don’t stop taking your medicine. You’ll need ongoing treatment for your schizophrenia. And your symptoms may come back if you miss a dose. If you want to change or stop your medicine, talk to your doctor. They’ll let you know when it’s safe to adjust your aripiprazole.

If you want to get pregnant, talk to your doctor. It may not be safe for you or your baby for you to stop your schizophrenia treatment. Your doctor can help you decide what to do about your medicine. You should also know that aripiprazole will get into your breast milk. Talk to your doctor before you start breastfeeding.

Aripiprazole | Atypical Antipsychotic Side Effects

About aripiprazole

Please note

Thinking about trying medication? Read our guide

How aripiprazole works

Aripiprazole is a ‘second-generation antipsychotic’ (sometimes described as an ‘atypical antipsychotic’).

Research suggests that mania and psychosis are more likely to occur when parts of the brain have too much of a chemical called dopamine. This theory is based on the fact that amfetamines, which are stimulants that release dopamine, can bring on psychosis in people who do not have the condition.

An antipsychotic medicine helps to adjust the levels of dopamine and other chemicals available in your brain. Aripiprazole reduces dopamine activity where it is too high, helping with symptoms like hallucinations. It also increases dopamine activity in areas of the brain where it is low, helping with symptoms like poor motivation.

Find out more about mania and hypomania

There are side effects of aripiprazole, such as drowsiness and weight gain, but the positives outweigh the negatives.

Emma, 24

Taking aripiprazole for schizoaffective disorder

Aripiprazole and everyday life

Frequently asked questions

It can take a few days, or sometimes a few weeks, for aripiprazole to start helping you. You may not feel the full to effects of the medication for four to six weeks. It’s hard to be exact as aripiprazole works differently for each person.

If you have seen no change in symptoms after two or three weeks, you should talk to your doctor about your progress.

A side effect of aripiprazole can be both weight loss and weight gain, although it is less likely to cause weight gain than other antipsychotic medicines.

It is very difficult to know how it will affect each person who takes it.

Sometimes aripiprazole is given to people taking other antipsychotics to not only help their symptoms but also to reverse some of the weight gained.

Your doctor should measure your weight regularly when you are taking aripiprazole.

Young people will gain some weight each year as they grow, but anything more than that should be watched.

If you put on weight, there are other antipsychotic medicines you can try, or ways to try and lose it again. Talk to your doctor about this if it worries you.

You may want to let your family and friends know you are taking aripiprazole so they can support you and help you look out for side effects.

For guidance on this, check out our page on getting support with your medication.

Aripiprazole may make you feel very sleepy but may also make it hard to get to sleep.

Sleepiness has been shown to affect young people more than adults.

See how it affects you for the first few days of taking it.

Go back to your doctor if this causes a big problem for you.

Alcohol

You can drink alcohol while taking aripiprazole, but the two together could make you very sleepy.

During the first few days, it might be best to stop drinking alcohol until you see how the medicine affects you.

If you want to drink alcohol, plan how you will get home safely if you feel sleepy.

Street drugs

Be careful if you are also using street drugs.

Antipsychotics block the effect of dopamine, so this means the ‘high’ may not be as ‘high’ as before from any drug. You may be tempted to increase your dose of the drug to make up for it, but this could be dangerous.

Cannabis can make drowsiness worse with aripiprazole.

Cannabis and other drugs may have their own side effects on your mental health, like anxiety or psychosis. For more information, have a look at our drugs and alcohol page.

Methadone can make drowsiness worse with aripiprazole.

Aripiprazole could reduce your craving for cocaine and could reduce the level of happiness that you feel when taking cocaine.

Aripiprazole and stimulant drugs such as amfetamines can affect the heart, and this can be dangerous when taken together.

Tell your doctor or pharmacist before you take aripiprazole if you are prescribed any other medication, to check that the combination is safe.

Before you start taking aripiprazole, tell your doctor if you are taking any other medications including things you have bought over the counter and topical applications that you put on your skin.

The tablets contain lactose so they may not be suitable for you if you have problems eating some sugars or dairy (milk-based) products.

The orodispersible tablets (melts) contain aspartame, which can be a problem for people with a condition called phenylketonuria.

The oral solution (liquid) contains sucralose. This should not affect your blood sugar if you’re diabetic.

Let your pharmacist know if you have any food allergies or intolerances, and always check with them if you’re concerned about any of the ingredients in your medication.

Do not drive a car or ride a bike just after you start taking aripiprazole.

Taking aripiprazole may make you feel very tired or dizzy and affect your eyesight when you start taking it.

This could affect you if you drive a car, ride a bike, or do anything else that needs a lot of focus. It might be best to stop doing these things for the first few days, until you know how it affects you.

Do not worry - most people drive as normal while taking aripiprazole.

Pregnancy

There is nothing to suggest aripiprazole will harm the developing baby during pregnancy.

If you decide to carry on taking aripiprazole through your pregnancy, you should talk to your doctor and midwife about it before the birth.

Your dose may need to increase later in your pregnancy as the body gets rid of aripiprazole more quickly. After delivery, your dose will go back to what it was before.

Post-natal

Aripiprazole can cause some symptoms in newborn babies – for instance, your baby might be born a little earlier than expected and may suffer from agitation, muscle spasm or weakness, shaking, drowsiness, feeding problems or breathing problems.

You will need help from the midwife and doctors, so it is better if they are looking out for these side effects. These usually are mild and go away in a few days without treatment.

Breastfeeding

Aripiprazole is passed to the baby in breast milk in small amounts. Breastfeeding may offset some of the symptoms. Talk to your doctor or midwife about your feeding options.

Sex

Aripiprazole is unlikely to cause side effects that affect your sex life (and is also less likely to do so than other antipsychotic medications).

If it works for you, aripiprazole may have a positive effect on your sex life as your symptoms settle, and you can concentrate on your relationships.

If you have a penis, you can get an erection that is painful and lasts for a long time (priapism) when taking aripiprazole. If this happens, you must go to a doctor straight away.

Fertility

There is no information to suggest aripiprazole has any effects on fertility.

You should use a good contraceptive while taking aripiprazole and talk to your doctor about options if you are trying to get pregnant.

Aripiprazole is not a banned substance in sport.

Taking aripiprazole may make you feel tired and dizzy, and affect your eyesight. This could be dangerous in some sports so it might be best not to take part in them for the first few days or weeks, until you know how it affects you.

Do not worry - most people do sports as normal while taking aripiprazole.

Try not to take aripiprazole for the first time just before your exams.

Aripiprazole could make you feel very tired and dizzy, make you feel restless and affect your eyesight.

You should talk to your doctor about any future exams if you are starting aripiprazole. You might decide together to delay starting it until you have completed them.

If they are more than a week away, however, you might find that it is better to start aripiprazole to improve your motivation to study.

Do not worry - most people take exams as normal while taking aripiprazole.

Your doctor should know

Uses, warnings, safety and side effects of aripiprazole

Taking aripiprazole

You should only take aripiprazole as agreed with your doctor

You can take aripiprazole as tablets, orodispersible tablets (melts), liquid or a long-acting monthly injection.

You will get the best effect from aripiprazole if you take it regularly.

Make sure that you know your dose. If it's not written on the label, check with your pharmacist or doctor.

You will usually take your dose once a day.

It doesn’t matter what time you take it each day – choose a time that you can always remember. This could be a mealtime, or when you brush your teeth.

You can take the tablets or liquid before or after food.

For the normal coated tablets, swallow them whole with a drink of water - if you chew them, they taste bitter.

To take an orodispersible tablet (melt), put one on your tongue and let it dissolve there. You can also dissolve it in some water if you prefer.

You cannot mix the oral solution with any drink or food. It must be taken on its own.

A doctor or nurse can give you a fast-acting dose of aripiprazole by injection if you are very agitated. You can have a tablet at the same time – under the supervision of a doctor – which will make the effect last longer.

If you start receiving the long-acting injection, you may also have be given some tablets to take until the medicine level is high enough in your body.

What should I do if I miss a dose of aripiprazole?

If you forget to take a dose, then just take it as soon as possible.

If you forget to take it by your next dose, only take the next dose.

Do not take a double dose.

What will happen if I forget to take my aripiprazole?

If you forget to take your medicine for a few days, you may start getting your old symptoms back. Talk to your doctor if this happens.

Stopping the use of aripiprazole

Stopping the medication causes the balance of chemicals in the brain to change.

Once you start taking an antipsychotic medicine, the brain adjusts to having a new level of dopamine around. If you stop taking it suddenly, the balance starts to change, and your old symptoms could return.

You could also experience some unpleasant withdrawal symptoms like headache, feeling sick and sleep problems.

You can stop taking aripiprazole safely with your doctor’s help. They will work with you to reduce your dose gradually rather than stopping suddenly. The speed at which you reduce depends on how unwell you were and how long you have been on aripiprazole.

Warnings and safety

Safety headlines

If you have taken more aripiprazole than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately – even if you do not feel any different. Take a friend with you if possible, in case you start to feel ill on the way.

While taking aripiprazole, some people may think about hurting themselves or taking their own lives. You must go straight to hospital with your tablets if you have any of these thoughts.

Aripiprazole can cause serious side effects like allergic reactions (difficulty breathing, swelling of your face or throat, itching skin lumps) and other serious symptoms, which are listed under the 'Side effects' tab. Go to a hospital if you experience any of these effects, taking your medicine with you.

Stopping aripiprazole suddenly might cause unpleasant withdrawal effects – go to your doctor if you want to stop, or if you are having these effects.

You might feel sleepy or dizzy in the first few days after taking aripiprazole – do not drive a car, ride a bike or operate machines until you see how this affects you.

If you take aripiprazole while you are pregnant, there is nothing to suggest it will harm the developing baby, though the medication can cause symptoms in newborn babies. Use good contraception while you are taking aripiprazole and tell your doctor if you want to start trying for a baby.

When to go to the hospital

If you have taken more aripiprazole than the dosage recommended by the doctor who prescribed it to you, go to A&E and take your medication with you - even if you don’t feel different. Take a friend with you if possible, in case you start to feel ill on the way.

You might get any of the following signs:

tiredness and sleepiness
fast heartbeat
diarrhoea
feeling or being sick
fainting or losing consciousness
strange movements of your muscles that you cannot control

While taking aripiprazole, some people think about hurting themselves or taking their own lives. This can happen to anyone, including people who are under 18. You must go straight to hospital with your tablets if you have any of these thoughts. Take a friend or family member with you to keep you safe on the way.

Stop taking your medicine and seek medical help straight away if you get any of the following symptoms:

difficulty swallowing; swelling in the mouth, tongue, face and throat; itching or a rash. These could indicate an allergic reaction to the medication
muscles going stiff or rigid with high fever, sweating, looking pale, feeling strange and fainting or losing consciousness, or tachycardia (very rapid or irregular heartbeat). These may indicate a rare but life-threatening side effect called neuroleptic malignant syndrome.

When to see your doctor

If you start to experience muscle spasms or abnormal bodily movements that you cannot control, you should go and see your doctor as soon as possible.

Antipsychotic medications can cause a wide variety of problems with movement such as tremors, restlessness, agitation and unusual movement of the lips, tongue, hands or pelvis. If the movements are severe then you might find it difficult to speak, eat or breathe. These are called extrapyramidal side effects (EPS). Aripiprazole is less likely to cause these movements than some of the other antipsychotics.

A subgroup of the movement side effects is called tardive dyskinesia. This is an uncommon side effect of aripiprazole. It occurs in less than one in 100 people and can be a legacy of taking earlier antipsychotics.

The first sign might be some movements of your tongue that you cannot control, and they may be quite regular and rhythmic. The problem with tardive dyskinesia is that it might not stop, even if you stop taking your medicine.

If you notice it early and act with your doctor, the problem should not get worse.

Monitoring

You should have your weight, height, waist circumference and blood pressure checked regularly while you are taking aripiprazole.

Your doctor should also do blood tests to check your liver, blood sugar, and some hormones before and regularly during your treatment.

You may also have a heart test called an electrocardiogram (ECG) before you start treatment - and periodically while taking aripiprazole - if you are at risk of heart disease.

Side effects of aripiprazole

In the first two or three weeks of taking aripiprazole, side effects (such as feeling agitated and restless, or feeling sick) may make you feel generally worse. They should wear off quite quickly but if they are a problem, speak to your doctor or care team.

The side effects that come with aripiprazole are different to those of many other antipsychotics, but they can be serious.

Do not stop taking the tablets until you talk to your doctor, or you may get withdrawal symptoms as well.

Young people aged 13 and over are more likely than adults to get the following side effects:

extreme tiredness and sleepiness
dry mouth
strange movements and twitches of muscles
dizziness
increased appetite and weight gain
restlessness
pain in the abdomen (belly)
fast heartbeat

Common side effects for both children and adults taking aripiprazole include:

uncontrollable twitching or jerking movements
feeling anxious or restless
feeling or being sick
discomfort or pain in the stomach
constipation (difficulty pooing)
lightheadedness
trouble sleeping
blurred eyesight

There are other side effects that you can get when taking this medicine – we have only included the most common ones here. Please look at the paper leaflet inside your medicine box, or ask a doctor or pharmacist, if you want to know if you are getting a side effect from your medicine.

If you do get a side effect, please think about reporting it to the 'Yellow Card' scheme.

Aripiprazole has also been known to make people feel like gambling to extremes. If you have ever had problems with gambling in the past, you should talk to your doctor about this before you take it.