Alternatives to Abilify: What Are Your Options?

If you've been unable to fill your Abilify (Aripiprazole) prescription — whether because of a supply issue, cost, or side effects — you may be wondering what other medications are available. The good news is that there are several effective alternatives in the same drug class that your doctor may consider.

This guide covers what Abilify is, how it works, and the most common alternatives your prescriber might recommend. Important: Never switch or stop a psychiatric medication on your own. Always work with your doctor to find the right option for you.

What Is Abilify?

Abilify is the brand name for Aripiprazole, an atypical antipsychotic medication. It's one of the most widely prescribed psychiatric drugs in the United States, with more than 7 million prescriptions each year.

Abilify is FDA-approved to treat:

• Schizophrenia (adults and teens 13–17)
• Manic or mixed episodes of Bipolar I Disorder (adults and children 10–17)
• Major Depressive Disorder as an add-on to an antidepressant (adults)
• Irritability associated with Autism (children 6–17)
• Tourette's Disorder (children 6–18)

It's available as oral tablets (2 mg to 30 mg), orally disintegrating tablets, oral solution, sublingual film, and long-acting injectable formulations.

How Does Abilify Work?

Abilify has a unique mechanism of action compared to most antipsychotics. It works as a partial agonist at dopamine D2 receptors, which means it can both boost and reduce dopamine signaling depending on what the brain needs. It also acts on serotonin receptors (5-HT1A and 5-HT2A), helping to stabilize mood and reduce psychotic symptoms.

This "dopamine stabilizer" effect is why Abilify tends to cause less sedation and weight gain than some other antipsychotics — though side effects like akathisia (restlessness), nausea, and insomnia are still common. For a deeper dive, see our post on how Abilify works.

Why Might You Need an Alternative?

There are several reasons you might need a different medication:

• Availability issues: Your pharmacy can't find Aripiprazole in stock (learn why)
• Side effects: Akathisia, weight gain, or impulse control problems are bothering you
• Cost: Even generic Aripiprazole may be out of budget without insurance
• Lack of response: Abilify isn't adequately controlling your symptoms

Alternative 1: Brexpiprazole (Rexulti)

Brexpiprazole, sold as Rexulti, is the closest relative to Abilify. Developed by the same manufacturer (Otsuka), it works through a very similar mechanism — partial agonism at dopamine D2 and serotonin 5-HT1A receptors.

FDA-approved for:

• Schizophrenia in adults
• Adjunctive treatment for Major Depressive Disorder in adults
• Agitation associated with Alzheimer's dementia

Key differences from Abilify:

• May cause less akathisia (restlessness) than Aripiprazole
• Slightly more weight gain on average than Abilify
• Only available as brand-name — no generic yet, so it's more expensive (around $1,000–$1,400/month without insurance)
• Typical dose: 1–4 mg once daily

Rexulti is a strong option if akathisia on Abilify has been a problem for you.

Alternative 2: Quetiapine (Seroquel)

Quetiapine, sold as Seroquel (immediate-release) and Seroquel XR (extended-release), is another atypical antipsychotic widely used for many of the same conditions.

FDA-approved for:

• Schizophrenia
• Bipolar disorder (manic, depressive, and maintenance episodes)
• Adjunctive treatment for Major Depressive Disorder

Key differences from Abilify:

• More sedating — often prescribed to help with sleep, but drowsiness can be a downside during the day
• Higher metabolic risk — more likely to cause weight gain, increased cholesterol, and blood sugar changes
• Available as a generic — affordable at $10 to $30/month with discount cards
• Typical dose: 150–800 mg/day depending on indication

Quetiapine is a good option if insomnia is a major part of your symptoms, since its sedating properties can be therapeutic.

Alternative 3: Risperidone (Risperdal)

Risperidone, sold as Risperdal, is one of the most established atypical antipsychotics. It's often the first-line choice for children and adolescents with psychosis.

FDA-approved for:

• Schizophrenia
• Bipolar mania
• Irritability associated with Autism (ages 5–16)

Key differences from Abilify:

• More prolactin elevation — can cause hormonal side effects like breast tenderness, menstrual changes, or sexual dysfunction
• More weight gain than Aripiprazole
• Available as a generic — typically $10 to $25/month with discount cards
• Available as a long-acting injection (Risperdal Consta) for patients who need it
• Typical dose: 1–6 mg/day

Alternative 4: Ziprasidone (Geodon)

Ziprasidone, sold as Geodon, is an atypical antipsychotic with a relatively favorable metabolic profile.

FDA-approved for:

• Schizophrenia
• Bipolar mania (acute)

Key differences from Abilify:

• Lower weight gain risk — one of the most weight-neutral atypical antipsychotics
• Must be taken twice daily with food (at least 500 calories per meal) for proper absorption
• QTc prolongation risk — requires monitoring of heart rhythm, especially in patients with cardiac history
• Available as a generic — around $15 to $40/month with discount cards
• Typical dose: 40–160 mg/day in two divided doses

Ziprasidone is worth discussing with your doctor if you're concerned about weight gain.

How to Choose the Right Alternative

Every patient is different, and the best alternative depends on your specific situation. Here are some factors your doctor will consider:

• Your diagnosis: Not all alternatives are approved for every condition Abilify treats
• Side effect profile: If akathisia bothers you, Rexulti may be better. If weight gain is a concern, Ziprasidone could be ideal.
• Cost and insurance: Generic options like Quetiapine and Risperidone are much cheaper than brand-name Rexulti
• Other medications: Drug interactions vary — check our guide on Abilify drug interactions for context
• Lifestyle factors: Ziprasidone requires twice-daily dosing with meals, while Abilify and Rexulti are once daily

Before You Switch: Try Finding Abilify First

If you're only considering an alternative because you can't find Aripiprazole at your pharmacy, it's worth trying a few more steps before switching medications. Psychiatric medication changes can cause side effects and adjustment periods, so staying on your current medication is usually preferable if possible.

• Use Medfinder to find Abilify in stock near you
• Try independent pharmacies
• Ask about mail-order options
• Check if a different generic manufacturer's version is available

Final Thoughts

Abilify is an excellent medication, but it's not the only option. If you need to switch — whether for availability, cost, or side effect reasons — Brexpiprazole, Quetiapine, Risperidone, and Ziprasidone are all proven alternatives that your doctor can help you evaluate.

For more information about Abilify itself, visit our guides on what Abilify is and Abilify side effects. And if cost is a factor, don't miss our post on how to save money on Abilify.