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Arizole

Arizole (Aripiprazole 5–30 mg) — D2 partial-agonist atypical for schizophrenia, bipolar mania, MDD adjunct. metabolically cleanest atypical — akathisia is main side effect.

Medicinsk gennemgået af Morgan Ellis — Apoteksforsker · 8 års erfaring  · Sidst gennemgået: maj 2026

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⚡ Hurtigt svar

Arizole (Aripiprazole 5 / 10 / 15 / 20 / 30 mg) is an atypical antipsychotic with a unique D2 partial-agonist mechanism. Used for schizophrenia, bipolar mania and maintenance, MDD adjunct, and irritability in autism. Most metabolically clean of the atypicals — minimal weight gain, minimal sedation.

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What Arizole is and how it works

Arizole is an aripiprazole tablet supplied by Sun Pharma. Available strengths: 5 / 10 / 15 / 20 / 30 mg. Aripiprazole is mechanistically distinct from other atypical antipsychotics: it acts as a partial agonist at dopamine D2 and serotonin 5-HT1A receptors and a full antagonist at 5-HT2A receptors. The partial-agonist profile means it functions as an antagonist where dopamine activity is high (treating positive symptoms in schizophrenia) and as a weak agonist where dopamine activity is low (preserving cognition, lowering risk of motor side effects and hyperprolactinaemia).

Indikationer og dosering

IndikationStartdosisMåldosisMaksimal dosis
Schizophrenia (adult)10–15 mg OD10–30 mg OD30 mg
Schizophrenia (adolescent ≥ 13 y)2 mg OD × 2 d → 5 mg × 2 d → 10 mg10 mg OD30 mg
Bipolar mania (adult)15 mg OD15–30 mg OD30 mg
MDD adjunct (with antidepressant)2–5 mg OD5–10 mg OD15 mg
Autism irritability (≥ 6 y)2 mg OD5–10 mg OD (weight-based)15 mg
Tourette syndrome (≥ 6 y)2 mg OD5–20 mg OD20 mg

Single daily dose, with or without food. Titrate slowly in patients sensitive to akathisia.

Vigtige sikkerhedsovervejelser

FDA black-box — dementia-related psychosis

All atypical antipsychotics carry an FDA black-box warning for increased mortality (mostly cardiovascular and infectious) when used to treat behavioural disturbance in older adults with dementia. Atypicals are not approved for dementia-related psychosis or agitation. Use in this population is off-label, last-resort, time-limited, and requires explicit risk-benefit conversation.

Akathisia is the dominant side effect

Aripiprazole produces less weight gain, less sedation, and less prolactin elevation than other atypicals — but more akathisia (an inner sense of restlessness, often described as “needing to move”, “skin crawling”, or “can’t sit still”). Akathisia is the most common cause of aripiprazole discontinuation. Manage with dose reduction, propranolol 20–80 mg/day, or switch.

Impulse-control disorders (rare)

Pathological gambling, hypersexuality, compulsive shopping, and binge eating have been reported on aripiprazole — caused by the partial D2/D3 agonism. Stops on discontinuation. Ask explicitly at follow-up.

Suicidality black-box (under-25 in MDD adjunct use)

When used as an antidepressant adjunct, the under-25 suicidality warning applies.

Almindelige bivirkninger

  • Akathisia — most common reason for discontinuation (15–25%).
  • Insomnia, anxiety, restlessness — common at initiation; settles in many.
  • Nausea, vomiting — first 1–2 weeks.
  • Vægtøgning — modest (less than olanzapine, clozapine, quetiapine).
  • Sedation — mild relative to other atypicals.
  • Prolactin — usually decreases (D2 partial agonism).
  • EPS / tardive dyskinesia — uncommon at usual doses.

Lægemiddelinteraktioner

  • Stærke CYP3A4-hæmmere (azoles, clarithromycin, ritonavir) — halve aripiprazole dose.
  • Strong CYP2D6 inhibitors (paroxetine, fluoxetine, bupropion, quinidine) — halve dose.
  • Strong CYP3A4 inducers (rifampicin, carbamazepine, phenytoin, St John’s wort) — double dose or switch.
  • Other QT-prolonging drugs — generally safer than other atypicals on QT but additive risk possible.
  • Antihypertensiva — additive hypotension at initiation.

Graviditet, amning, pædiatrisk

Pregnancy: limited data; weigh against untreated illness. Breastfeeding: passes into milk; usually compatible with monitoring. Paediatric: licensed from 6 (autism), 10 (bipolar), 13 (schizophrenia).

Opbevaring

Opbevares ved 15–30 °C i original emballage.

Ofte stillede spørgsmål

How is Arizole different from other antipsychotics?

Aripiprazole is the most prescribed dopamine partial agonist (along with brexpiprazole and cariprazine). The clinical translation: less weight gain, less sedation, less prolactin elevation than olanzapine/risperidone/quetiapine — but more akathisia and a small impulse-control disorder signal.

What is akathisia?

Akathisia is an inner sense of restlessness — often described as “needing to move”, “skin crawling”, or “can’t sit still”. It is the most common reason patients stop aripiprazole. Tell your prescriber early — it’s manageable with dose reduction, propranolol 20–80 mg/day, or sometimes a benzodiazepine bridge while the dose is titrated.

Will Arizole make me gain weight?

Modest weight gain — typically 1–3 kg over 6 months, much less than olanzapine, clozapine, or quetiapine. Aripiprazole is often the atypical of choice when weight is a primary concern.

Can Arizole be used with an antidepressant?

Yes — aripiprazole is FDA-approved as an adjunct to antidepressants in major depression at low doses (2–10 mg). Combination is well-evidenced (CO-MED, others) and well-tolerated.

Why does Arizole sometimes cause gambling or other compulsions?

The D2/D3 partial agonism extends to limbic reward circuits. A small subset of patients develops impulse-control disorders (pathological gambling, hypersexuality, compulsive shopping, binge eating). Always asked explicitly at follow-up. Stops on discontinuation.

How long until Arizole works?

Antipsychotic effect usually visible within 1–2 weeks for positive symptoms; full effect at 4–6 weeks. Antidepressant adjunct effect at 2–6 weeks. Mood-stabilising effect in bipolar within days for acute mania.

Can Arizole be stopped abruptly?

Generally yes — withdrawal is mild because of aripiprazole’s long half-life (~75 hours). However, abrupt cessation in schizophrenia and bipolar carries a high relapse risk. Never stop without prescriber agreement.

Will Arizole affect my fertility?

Aripiprazole rarely raises prolactin — fertility is not usually affected. Compare risperidone (raises prolactin substantially, common cause of amenorrhoea, galactorrhoea, and male hypogonadism).

What about driving on Arizole?

Sedation is relatively mild. Most patients on stable doses drive normally — but the first 1–2 weeks of titration may impair reaction time. Avoid driving until tolerability is known.

Are LAI (long-acting injectable) versions available?

Yes — depot aripiprazole formulations (Maintena monthly, Asimtufii bimonthly) are available for adherence support in schizophrenia. The oral tablet version is the standard initiation and dose-titration formulation.

Andre Mental Sundhedsmedicin

Medicinsk ansvarsfraskrivelse. Denne side er udelukkende til informationsformål og er ikke erstatning for individuel lægevejledning. Behandling med psykofarmaka bør iværksættes, overvåges og tilpasses af en kvalificeret kliniker. Hvis du eller nogen du kender er i akut selvmordskrise, skal du kontakte lokale akutteams eller ringe til din lands selvmordsforebyggende kriselinje (US/Canada: 988; UK: Samaritans 116 123; international liste: findahelpline.com).

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