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 along with a lower risk of side effects than first-generation antipsychotics. Efficacy, fewer adverse events, and convenience make for an enticing trio of features, but medications work differently for everyone, so sometimes an alternative is needed. Alternatives to a second-generation antipsychotic may also be preferred because of side effects like weight gain or metabolic changes. Let’s delve into the options.

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What can I take instead of Abilify?

Important differences exist within members of the class of second-generation antipsychotics, also known as atypical antipsychotics. It’s a fairly large group, and includes well-known drugs like Seroquel (quetiapine) and Zyprexa (olanzapine), as well as newer drugs, such as Invega (paliperidone). Although these are drugs similar to Abilify, atypical antipsychotics vary in the amount and type 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 also improve depressive symptoms. Based on the various attributes of members of the class, the best choice among them can differ from one person 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 medications. Unfortunately, these typical, or first-generation, antipsychotics can have more side effects. 

Other mood stabilizers. such as Lamictal (lamotrigine) or lithium, may present as effective Abilify alternatives without weight gain and other side effects associated with antipsychotics. However, these medications come with a different set of potential side effects, drug interactions, and some need close monitoring with blood work.

An alternative to Abilify for depression might involve switching to a different atypical antipsychotic or to an antidepressant that hasn’t yet been tried.

Top 5 Abilify alternatives

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

1. Seroquel XR

If someone has a movement disorder or has experienced extrapyramidal symptoms (EPS) before, Seroquel XR (quetiapine) might be a better choice. Tardive dyskinesia and extrapyramidal symptoms (EPS) are potential side effects of antipsychotic medication. The signs can include abnormal movements such as restlessness, agitation, rigidity, slowed movement, difficulty 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. 

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. Seroquel is also more sedating than Abilify.

2. Zyprexa

Zyprexa (olanzapine) is one of the more sedating second-generation antipsychotics, which is saying a lot for a group known for having drowsiness among its 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 cytochrome P450 liver enzymes, which are influenced by drugs such as carbamazepine and fluoxetine, which are also used to treat mental health conditions. Invega (paliperidone) is not significantly metabolized by these liver enzymes, meaning that drug interactions are less of a concern. 

4. Lamictal

Lamictal (lamotrigine) 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, such as weight gain, elevated cholesterol, and elevated blood sugar. For those experiencing these side effects or at high risk of them, the treating healthcare team may consider Lamictal.

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 alternatives to Abilify that have been investigated. Despite these studies, reviews of complementary and alternative medicine and nutraceuticals have generally concluded that more research is needed before they can be recommended.

How to switch to an Abilify alternative

Mood disorders like bipolar disorder 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 and review your medication options.