Medication & prescriptions
Understanding aripiprazole’s side effects
Learn about aripiprazole, or Abilify, side effects, from common symptoms to serious risks, plus tips on safe use and when to seek medical help.
By Dr. Juli Fraga, Psy.D • Clinically reviewed by Dr. Anik Saha, M.D.
If you’ve been diagnosed with bipolar disorder, schizophrenia, Tourette syndrome, or autism spectrum disorder, your doctor may prescribe you aripiprazole, also known by the brand name Abilify. Abilify is officially FDA-approved as an add-on treatment for adults with major depressive disorder (MDD) who have had an inadequate response to standard antidepressants.
Like all medications, aripiprazole can come with side effects, including common experiences like anxiety, insomnia, and headaches. Understanding any potential side effects is important if you plan to start taking aripiprazole. When you know what to look for, you're more likely to notice side effects and be better equipped to inform your provider.
We’ve put together a comprehensive guide to help patients and caregivers recognize common and serious side effects of aripiprazole. Read on to learn more about medication safety and when to seek help.
What is aripiprazole?
Aripiprazole is in a class of medications called antipsychotics. Just like antidepressants treat symptoms of depression, aripiprazole is prescribed to treat symptoms of psychosis, such as hearing or seeing things that aren’t there. (Despite the name, antipsychotics are used to treat a wide range of conditions beyond psychosis — including depression and bipolar disorder.) This medication works by balancing levels of serotonin and dopamine in the brain. These neurotransmitters help regulate mood, motivation, and thinking.
Aripiprazole is used to treat a range of mental health conditions, including schizophrenia, bipolar disorder, Tourette syndrome, and irritability associated with autism spectrum disorder. It is also FDA-approved as an add-on (or adjunctive) treatment for major depressive disorder when standard antidepressants haven't fully worked.
Most common side effects of aripiprazole
Aripiprazole can help reduce symptoms like hallucinations, mood swings, and depressive symptoms. As with many psychiatric medications, however, side effects are possible.
Here are some common side effects you may experience.
- Nausea or vomiting: Nausea or vomiting can occur, especially when first starting the medication. These side effects often improve as your body adjusts.
- Dizziness: You may feel like you're riding a tilt-a-whirl or feel off-balance. Clinical trials show that 3 to 7% of people may experience this side effect. While uncomfortable, dizziness usually improves over time.
- Sleepiness or fatigue: You may feel extra groggy during the day or feel the need to go to bed early.
- Headache: After starting the medicine, you may experience more frequent headaches. Headaches typically resolve on their own, usually within 1-2 weeks as your body adjusts to the medicine.
- Restlessness (akathisia): Akathisia is a feeling of restlessness or an inability to sit still. For example, you might rock back and forth when sitting or standing, or feel the urge to walk in place. Up to 18% of people experience this side effect shortly after they start taking the medicine.
- Anxiety: You may experience an increase in anxiety, such as worrying or unexplained feelings of fear, even when there’s no actual threat. Anxiety can also make your heart beat quickly and make your muscles feel tense.
- Increased appetite and weight gain: Ariprazole can cause metabolic changes for some people. This may result in weight gain, but it generally levels off after one year.
Serious side effects of aripiprazole
Like many psychiatric medications, aripiprazole can cause some serious side effects. While rare, these side effects require immediate medical attention from a healthcare professional.
- Uncontrolled muscle movements (tardive dyskinesia): Tardive dyskinesia can cause involuntary movements, such as twitching, frequent blinking, or facial grimacing. This side effect is most common in older adults. This is a rare side effect, but it does require prompt medical attention.
- Neuroleptic malignant syndrome (NMS): This is a very rare, but potentially life-threatening side effect. Neuroleptic malignant syndrome causes a high fever, rigid muscles, rapid heartbeat, tremors, and agitation or confusion.
- Urges to engage in impulsive behavior: Experiencing sudden urges to act impulsively, such as spending a lot of money, gambling, engaging in hypersexual behavior, or taking risks that are unusual for you.
- High blood sugar: Due to potential metabolic changes, aripiprazole can raise your blood sugar. Symptoms to look out for include frequent urination, excessive thirst, weight loss, and fatigue.
- Sexual side effects: While rare, some people do experience sexual side effects, such as erectile dysfunction, changes in libido, or an inability to have an orgasm.
- Seizures: Psychiatric medications like aripiprazole can lower your seizure threshold, making you more prone to seizures. While this side effect isn’t common, a seizure does require immediate medical attention from a doctor.
- Allergic reactions: Skin rash, hives, itching, and swelling of the face or throat are all signs of a possible allergic reaction. In very rare instances, people may have difficulty breathing or difficulty swallowing. If this happens, dial 911.
- Increased risk of stroke or death: Among older individuals, and particularly people with a dementia diagnosis, stroke and death are rare side effects. Because of this risk, prescribers do not recommend aripiprazole for dementia-related psychotic symptoms, such as hallucinations and delusions.
- Suicidal thoughts: Aripiprazole carries an FDA boxed warning for an increased risk of suicidal thinking or behavior in children, adolescents, and young adults up to age 24, especially when used to treat depression. Watch for new or worsening thoughts of self-harm, agitation, or rapid mood changes — and let your prescribing provider know immediately if any of these occur.
What may interact with this medication?
Drug, substance, or lifestyle interactions may affect how aripiprazole works or increase side effects. Here are some important things to consider.
- Other medications affecting the central nervous system: Combining aripiprazole with other medications that affect the central nervous system, such as opioids, benzodiazepines, and anti-seizure medications, can increase side effects like drowsiness and slowed reflexes.
- Alcohol use: Mixing alcohol with aripiprazole can worsen side effects like nausea, fatigue, and low blood pressure.
- Drugs that affect liver enzymes: Some of these medications can reduce aripiprazole's effectiveness, while others increase the risk of side effects. Drugs that can reduce the effectiveness of aripiprazole include certain anti-seizure medications. For a complete list of these medications, consult with a medical professional.
- Blood pressure medications: Combining aripiprazole with blood pressure medications can increase the risk of low blood pressure.
- Antihistamines: Mixing aripiprazole with antihistamines like Benadryl can worsen grogginess and fatigue.
- Grapefruit juice: Grapefruit juice can slow down a liver enzyme that helps your body clear medication. Drinking grapefruit juice while taking aripiprazole can slow how your body clears the medication, leading to more side effects. Your prescriber may recommend avoiding it.
Additional substances and medications can interact with aripiprazole, so it’s important to consult a health care professional before starting — and while taking — the medication.
How should I store this medication?
Aripiprazole should be stored at room temperature (between 59 and 86 degrees Fahrenheit). Keep the medication in its original container and keep it away from extreme heat, moisture, and light.
Also store this medication out of the reach of children and pets, and discard any medication that’s past its expiration date. It’s always a good idea to review the medication instructions and follow your doctor’s instructions.
Abilify FAQs
What should I tell my care team before I take this medication?
Let your health care team know if you’ve ever had any adverse side effects to psychiatric medications, including anti-psychotics. Since aripiprazole can interact with other medicines, let your healthcare team know what medications you’re currently taking.
How should I use this medication?
Aripiprazole should be taken as prescribed by your doctor.
How long do Abilify side effects last?
Research shows that mild side effects like nausea, fatigue, and anxiety generally improve as your body adjusts to the medication dosage. Long-term use of aripiprazole may be associated with tardive dyskinesia and metabolic changes including weight gain and elevated blood sugar. Speak with your health care team about your side effects and any concerns you may have.
Find the right support for medication management
Starting aripiprazole can raise many questions about how the medicine works and any potential side effects. Speaking with a licensed prescribing provider is step one toward answers. A qualified psychiatrist, psychiatric nurse practitioner, or medical doctor can help you review your symptoms, answer questions, and support you in making informed decisions about your medical care.
Headway helps you find in-network providers, with a tool that allows you to filter professionals by specialty, insurance compatibility, and availability. We make it easy for you to find a licensed professional who can provide guidance and support without the guesswork.
This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.
© 2026 Therapymatch, Inc. dba Headway. All rights reserved. No part of this publication may be reproduced without permission.
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