Uses of Ariprex 15: - Schizophrenia - Mania Adult: PO Schizophrenia Initial: 10-15 mg once daily. Maintenance: 15 mg once daily. Max: 30 mg once daily without regard to food. Dose increment should not be made before 2 weeks, the time needed to achieve steady state. Bipolar mania 30 mg once daily. May reduce to 15 mg once daily according to tolerability. Major Depressive Disorder 2-5 mg/day PO initially; increased weekly PRN by <5 mg/day to dose range of 2-15 mg/day Elderly: Reduce initial dose. Schizophrenia 13-17 years: 2 mg/day PO initially; increased to 5 mg/day after 2 days; increased to recommended dosage of 10 mg/day after additional 2 days; may subsequently be increased by 5 mg/day; maintenance: 10-30 mg/day Bipolar Mania Acute manic or mixed episodes, either as monotherapy or as adjunct to lithium or valproate 10-17 years: 2 mg/day PO initially; increased to 5 mg/day after 2 days; increased to recommended dosage of 10 mg/day after additional 2 days; may subsequently be increased by 5 mg/day; maintenance: 10-30 mg/day Autism Irritability associated with autistic disorder <6>1 week to target dosage of 5 mg/day; may gradually be further increased PRN to 10 mg/day or higher; not to exceed 15 mg/day Tourette Disorder 6-18 years (<50 kg) Initiate at 2 mg/day PO with a target dose of 5 mg/day after 2 days The dose can be increased to 10 mg/day in patients who do not achieve optimal control of tics Dosage adjustments should occur gradually at intervals of no less than 1 week 6-18 years (?50 kg) Initiate at 2 mg/day PO for 2 days, and then increase to 5 mg/day for 5 days, with a target dose of 10 mg/day on day 8 The dose can be increased up to 20 mg/day for patients who do not achieve optimal control of tics Dosage adjustments should occur gradually in increments of 5 mg/day at intervals of no less than 1 week

Atypical neuroleptic drugs

Aripiprazole is an atypical antipsychotic that has both dopamine and serotonin receptors activity. It is a partial agonist of dopamine D2 receptors that relieves the symptoms of schizophrenia. It is characterized as a dopamine system stabilizer. It is a potent partial agonist at serotonin 5-HT1A receptors and antagonist at 5-HT2A receptors. This is associated with improvement of depressive, cognitive and negative symptoms.

How to use Aripiprazole: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Aripiprazole may be taken with or without food, but it is better to take it at a fixed time. Administration: Drugs that induce CYP3A4 (e.g. carbamazepine) could cause an increase in aripiprazole clearance and lower blood levels. Inhibitors of CYP3A4 (e.g. ketoconazole) or CYP2D6 (e.g. quinidine, fluoxetine or paroxetine) can inhibit aripiprazole elimination and cause increased blood levels. Increased CNS depression with ethanol. Adult Dose: Patients with known CV diseases (e.g. history of MI, IHD, CCF or conduction abnormalities), cerebrovascular diseases or conditions which would predispose patients to hypotension; Alzheimer's disease and dementia. Caution when operating hazardous machinery, including automobiles when taking aripiprazole. Pregnancy. Lactation: Excreted in human breast milk; a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother Renal Dose: Aripiprazole acts as a partial agonist at D2 and 5-HT1A receptors and as an antagonist at 5-HT2A receptors.

Hypersensitivity. Lactation. Children <18 yr.

Schizophrenia 13-17 years: 2 mg/day PO initially; increased to 5 mg/day after 2 days; increased to recommended dosage of 10 mg/day after additional 2 days; may subsequently be increased by 5 mg/day; maintenance: 10-30 mg/day Bipolar Mania Acute manic or mixed episodes, either as monotherapy or as adjunct to lithium or valproate 10-17 years: 2 mg/day PO initially; increased to 5 mg/day after 2 days; increased to recommended dosage of 10 mg/day after additional 2 days; may subsequently be increased by 5 mg/day; maintenance: 10-30 mg/day Autism Irritability associated with autistic disorder <6>1 week to target dosage of 5 mg/day; may gradually be further increased PRN to 10 mg/day or higher; not to exceed 15 mg/day Tourette Disorder 6-18 years (<50 kg) Initiate at 2 mg/day PO with a target dose of 5 mg/day after 2 days The dose can be increased to 10 mg/day in patients who do not achieve optimal control of tics Dosage adjustments should occur gradually at intervals of no less than 1 week 6-18 years (?50 kg) Initiate at 2 mg/day PO for 2 days, and then increase to 5 mg/day for 5 days, with a target dose of 10 mg/day on day 8 The dose can be increased up to 20 mg/day for patients who do not achieve optimal control of tics Dosage adjustments should occur gradually in increments of 5 mg/day at intervals of no less than 1 week

Common - Akathisia (inability to stay still) - Anxiety - Blurred vision - Constipation - Dizziness - Fatigue - Headache - Increased saliva production - Indigestion - Insomnia (difficulty in sleeping) - Nausea - Parkinsonism - Restlessness - Sleepiness - Tremor - Vomiting

Aripiprazole should not be used in pregnancy as no human trial is performed. Patients should be advised not to breast feed an infant if they are taking aripiprazole.

Precaution: Major depressive disorder, Schizophrenia, Acute manic episodes of bipolar disorder, Agitation, Irritability in autism

Aripiprazole at doses up to 1080 mg causes no fatalities. The signs and symptoms observed with aripiprazole overdose included nausea, vomiting, asthenia, diarrhea, and somnolence.

Atypical neuroleptic drugs

May be taken with or without food.

>10% Weight gain (8-30%),Headache (27%),Agitation (19%),Insomnia (18%),Anxiety (17%),Nausea and vomiting (11-15%),Akathisia (10-13%),Lightheadedness (11%),Constipation (10-11%) 1-10% Dizziness (10%),Dyspepsia (9%),Somnolence (5-8%),Fatigue (6%),Restlessness (6%),Tremor (6%),Dry mouth/xerostomia (5%) ,Extrapyramidal disorder (5%),Orthostatic hypotension (1-5%),Musculoskeletal stiffness (4%),Abdominal discomfort (3%),Blurred vision (3%),Cough (3%),Pain (3%),Myalgia (2%),Rash,Rhinitis <1% Altered mental status,Autonomic instability,Dysphagia,Hyperpyrexia,Muscle rigidity,Neuroleptic malignant syndrome (NMS),Seizure,Tardive dyskinesia