What You Should Know About Abilify Side Effects

Every medication comes with potential side effects, and Abilify (Aripiprazole) is no exception. The good news is that most people tolerate Abilify well, and many side effects are mild and temporary. But some are serious and require immediate medical attention.

This guide covers the most common and serious Abilify side effects based on FDA labeling, who's most at risk, and when you should contact your doctor.

What Is Abilify?

Abilify is an atypical antipsychotic medication used to treat schizophrenia, bipolar disorder, major depressive disorder (as an add-on treatment), irritability in autism, and Tourette's disorder. It works by balancing dopamine and serotonin activity in the brain. For a deeper dive, see our guide on what Abilify is and how it's used.

Common Side Effects of Abilify

These side effects are reported frequently in clinical trials and usually improve as your body adjusts to the medication:

• Akathisia (restlessness) — A feeling of inner restlessness or the need to keep moving. This is one of the most commonly reported side effects of Abilify.
• Insomnia — Difficulty falling or staying asleep, especially when first starting the medication.
• Nausea and vomiting — Stomach upset is common early in treatment and often improves within the first few weeks.
• Constipation — A frequent side effect that can often be managed with diet, hydration, and fiber.
• Dizziness — Feeling lightheaded, especially when standing up quickly.
• Headache — Mild to moderate headaches are common during the first weeks of treatment.
• Weight gain — Abilify tends to cause less weight gain than many other antipsychotics, but some patients still experience it.
• Drowsiness or sedation — Feeling sleepy or sluggish, though Abilify is generally less sedating than medications like Quetiapine (Seroquel).
• Blurred vision — Usually temporary and mild.
• Fatigue — General tiredness, especially during the first few weeks.
• Anxiety — Some people feel more anxious when first starting Abilify, though this often settles down.

Most of these side effects are dose-related, meaning they may improve if your doctor lowers your dose.

Serious Side Effects of Abilify

While less common, these side effects are serious and may require immediate medical attention:

Neuroleptic Malignant Syndrome (NMS)

This is a rare but life-threatening reaction. Symptoms include high fever, muscle stiffness, confusion, rapid heartbeat, and changes in blood pressure. Call 911 or go to the emergency room immediately if you experience these symptoms.

Tardive Dyskinesia

This involves involuntary, repetitive movements — often of the face, tongue, or jaw. The risk increases with long-term use. Tell your doctor right away if you notice unusual movements you can't control.

Metabolic Changes

Abilify can cause increases in blood sugar (hyperglycemia), cholesterol, and triglycerides. In some cases, this can lead to diabetes. Your doctor should monitor your blood sugar and lipid levels regularly while you're on Abilify.

Orthostatic Hypotension

A sudden drop in blood pressure when standing up, which can cause dizziness or fainting. This is more common when you first start the medication or increase your dose.

Impulse Control Problems

Some patients taking Abilify have experienced unusual urges, including compulsive gambling, binge eating, compulsive shopping, and hypersexuality. If you or your family notice any new compulsive behaviors, tell your doctor immediately.

Seizures

Abilify may lower the seizure threshold. People with a history of seizures should use it with caution.

Difficulty Swallowing (Dysphagia)

Antipsychotic medications, including Abilify, can cause difficulty swallowing, which may increase the risk of aspiration pneumonia.

Allergic Reactions

Rarely, Abilify can cause anaphylaxis or angioedema (severe swelling). Seek emergency care if you develop hives, swelling of the face or throat, or difficulty breathing.

Boxed Warnings

Abilify carries two FDA boxed warnings — the most serious type of safety alert:

1. Elderly patients with dementia-related psychosis — Abilify is not approved for this use. Elderly patients with dementia who take antipsychotics have an increased risk of death.
2. Suicidal thoughts in young people — Children, adolescents, and young adults taking antidepressants (Abilify is used as an add-on for depression) may have an increased risk of suicidal thinking and behavior. Close monitoring is essential, especially in the first few months of treatment.

Side Effects in Specific Populations

Children and Adolescents

Side effects in younger patients are generally similar to those in adults, with weight gain and drowsiness being more common. Abilify is FDA-approved for patients as young as 6 years old for certain conditions.

Pregnant and Breastfeeding Women

Babies exposed to Abilify during the third trimester may experience withdrawal symptoms or abnormal muscle movements after birth. Abilify passes into breast milk, so breastfeeding is generally not recommended while taking it. Talk to your doctor about the risks and benefits.

Older Adults

Older adults may be more sensitive to side effects like dizziness, falls, and orthostatic hypotension. As noted above, Abilify should not be used for dementia-related psychosis.

People with Diabetes or Metabolic Conditions

If you already have diabetes or high cholesterol, Abilify may worsen these conditions. Your doctor should monitor your blood sugar and lipid levels closely. Note that the oral solution contains sugar.

How to Manage Abilify Side Effects

Here are some practical tips for dealing with common side effects:

• Akathisia: Talk to your doctor. They may lower your dose or add a medication like propranolol to help.
• Insomnia: Take Abilify in the morning if it's keeping you awake at night. Practice good sleep hygiene.
• Nausea: Take Abilify with food. This often reduces stomach upset.
• Dizziness: Stand up slowly from sitting or lying positions. Stay hydrated.
• Weight gain: Maintain a healthy diet and regular exercise routine. Your doctor can help monitor your weight.
• Constipation: Drink plenty of water, eat high-fiber foods, and stay active.

Never stop taking Abilify suddenly without talking to your doctor first. Stopping abruptly can cause withdrawal symptoms or a return of your condition. If side effects are bothering you, your doctor can adjust your dose or explore alternatives to Abilify.

When to Call Your Doctor

Contact your doctor or seek emergency care if you experience:

• High fever, muscle stiffness, or confusion (signs of NMS)
• Uncontrollable movements of your face or body
• New or worsening suicidal thoughts
• Signs of high blood sugar (extreme thirst, frequent urination, blurred vision)
• New compulsive behaviors (gambling, binge eating, unusual sexual urges)
• Severe dizziness or fainting
• Difficulty swallowing or breathing
• Signs of an allergic reaction (hives, swelling, rash)

Final Thoughts

Abilify is an effective medication for many people, but understanding its side effects helps you stay safe and informed. Most side effects are manageable, especially with your doctor's guidance. The key is to stay in close communication with your healthcare team and report anything unusual.

If you're looking for Abilify at the best price, Medfinder can help you find it in stock near you. And for more information on how Abilify works in your body, check out our guide on Abilify's mechanism of action.