Abilify alternatives: What can I take instead of Abilify?

In this article:

• Abilify alternatives
• Seroquel XR
• Zyprexa
• Invega
• Lamictal
• Lithium
• Natural alternatives
• How to switch

In this article

• Abilify alternatives
• Seroquel XR
• Zyprexa
• Invega
• Lamictal
• Lithium
• Natural alternatives
• How to switch

Abilify (aripiprazole) is a second-generation antipsychotic medicine used primarily in the treatment of bipolar disorder, schizophrenia, and depression. Second-generation antipsychotics possess mood-stabilizing potential to go along with a lower risk of side effects than first-generation antipsychotics and an array of dosage forms. Efficacy, fewer adverse events, and convenience sound like an enticing trio of features, but Abilify may not be the best choice among the group. Furthermore, an alternative to a second-generation antipsychotic may be preferred based on the group’s side effects. Let’s delve into the other options.

What can I take in place of Abilify?

Important differences exist within members of the class of second-generation antipsychotics, which is also known as the atypical antipsychotics. It’s a fairly large group, and they vary in the mix of side effects, dosage forms, duration of action, and drug interactions. Dosage forms include oral tablets, disintegrating tablets, films, suspensions, and injectable versions. Some drugs from the class influence different neurotransmitters and may have more benefit to depressive symptoms. Based on the various attributes of members of the class, the best choice among them can differ from one patient to another.

Outside the class, first-generation antipsychotics are another option for the treatment of psychotic disorders, and beyond those, alternative mood stabilizers could be chosen. First-generation antipsychotics block dopamine receptors like second-generation versions, but they might be more potent for symptoms like hallucinations and delusions than atypical antipsychotic medication. Unfortunately, these typical, or first-generation, antipsychotics can have more side effects. Other mood stabilizers may present as effective options with fewer long-term side effects than the antipsychotics.

Top 5 Abilify alternatives

The following are some of the most common alternatives to Abilify.

1. Seroquel XR

Tardive dyskinesia and extrapyramidal symptoms (EPS) are potential side effects of antipsychotic medication. The signs can consist of abnormal movements like restlessness, agitation, rigidity, slowing of movement, trouble swallowing, and shakiness. In studies listed on their drug labels, Seroquel XR had a lower incidence of akathisia, an EPS complex with agitation and restlessness, than Abilify did in studies listed on their drug labels. 

If someone has a movement disorder or has experienced EPS before, Seroquel XR might be a better choice. The extended-release oral tablet still only requires once-daily dosing. However, according to their drug labels, study participants taking Seroquel XR reported more changes in heart rate and blood pressure than those taking Abilify.

2. Zyprexa

Zyprexa is one of the more sedating second-generation antipsychotics, which is saying a lot for a group known for having drowsiness among their common side effects. The side effects could be viewed as beneficial for those having difficulty sleeping, and a healthcare provider could advise a patient with bipolar disorder and insomnia to take Zyprexa at bedtime for a dual benefit on mood and sleep. Abilify, on the other hand, is less sedating, and although that characteristic may be preferable for some, it can also be associated with insomnia. Your medical provider can discuss the pros and cons of each antipsychotic option.

3. Invega

Interactions with other drugs can be a problem for Abilify and other antipsychotics. When transitioning from one antipsychotic to another, Abilify can nullify some of the effectiveness of the other drug. In addition, it is metabolized by the cytochrome P450 liver enzymes that are influenced by drugs like carbamazepine and fluoxetine, which are also used for treating mental health conditions. Invega is not significantly metabolized by these liver enzymes, meaning that drug interactions are less of a concern. 

4. Lamictal

Lamictal is an anticonvulsant that has proven efficacy for mood stabilization in bipolar 1 disorder. As an alternative to Abilify and atypical antipsychotics in general, Lamictal can avoid some of the negative class-inherent effects. Most notably, it avoids the adverse metabolic consequences. Abilify and other second-generation antipsychotics can be associated with weight gain, cholesterol elevation, and blood sugar elevation. For those experiencing these side effects or at high risk of them, Lamictal could be advised by the treating healthcare team.

5. Lithium

As a drug that has been around since the 1940s, lithium has a long track record for use in bipolar disorder. After all this time, lithium remains an alternative to antipsychotics for helping to stabilize mood in the setting of bipolar disorder. The cost of an old medication like lithium is quite low, but if cost is a concern when choosing between drugs, make sure you are using a SingleCare discount card at the pharmacy when comparing your options. 

Unfortunately, using lithium requires a high degree of caution and attention to contraindications, drug level monitoring, and drug interactions. These concerns have not stopped lithium from being prescribed by experienced psychiatry practitioners.

Natural alternatives to Abilify

There continues to be plenty of interest in finding an option outside the pharmacological world to treat mental health disorders like bipolar disorder and schizophrenia. Omega-3 fatty acids, vitamin D, and coenzyme Q10 are among the natural supplements that have been investigated. Despite these studies, reviews of complementary and alternative medicine and nutraceuticals have generally reached the conclusion that more research is needed before they can be recommended.

How to switch to an Abilify alternative

Mood disorders like bipolar and psychotic disorders like schizophrenia can be life-threatening. Considering a change from a treatment like Abilify to an alternative is a critically important decision that requires medical advice from a healthcare professional. As you have learned, options abound, but each has benefits and risks compared to Abilify. Sit down with your doctor to go over your concerns with Abilify and review other second-generation antipsychotics and choices from outside that class.