Aripiprazole: characteristics and side effects

The suffering of different mental disorders on the part of the population has meant that throughout the history, different mechanisms and measures to be applied have been sought in order to treat said affectations. Even in ancient cultures and prehistory, rituals such as trepanation have been carried out for this purpose. But over the years, different methodologies have been refined that are highly effective in treating these disorders.

Among them we find the synthesis of substances that eliminate or reduce symptoms: psychotropic drugs. With regard to schizophrenia, drug treatment is now considered to be of great importance for the maintenance and stabilization of patients. Y Among the many existing psychotropic drugs we can find aripiprazole, which we are going to talk about in this article.

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Aripiprazole: what is it?

Aripiprazole is a psychotropic drug classified as antipsychotic or neuroleptic, drugs specially designed to produce a positive effect on

the reduction and elimination of symptoms of schizophrenia and psychotic disorders, such as delusions and hallucinations and psychomotor agitation.

Among antipsychotics it is classified as atypical, because its creation is based on the attempt to develop effective drugs in the treatment of these symptoms without producing the level of side effects that the typical or classic ones have, as well as increase the effectiveness in the treatment of a type of symptomatology, the negative one (those symptoms that reduce the functionality of the patient's present abilities, such as impaired thinking and apathy), which typical antipsychotics do not treat or may even harm.

And in this task it is especially efficient, helping to fight both positive and negative symptoms. In addition to this, it has the advantage of having possible administration as an intramuscular injection in depot format (slow release) on a monthly basis, in these cases it is not necessary to take the drug by mouth continuously.

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Mechanism of action

Aripiprazole is, as we have said, an atypical antipsychotic. As with most of these types of neuroleptics, their effects are due to their action on two neurotransmission systems: dopamine and serotonin. However, its mechanism of action is somewhat different from the rest of the atypicals as regards the dopamine.

And although most antipsychotics, both typical and atypical, usually work by blocking dopamine D2 receptors in the brain, this is not the case with aripiprazole. This drug is in fact a partial agonist of D2 receptors, favoring in principle its presence in the brain. This in principle would allow to increase positive psychotic symptoms, but nevertheless the truth is that it reduces them.

This reduction is explained by the action on the serotonin. The rest of the atypicals decrease brain serotonin in such a way that it stops inhibiting dopamine in the areas that do not require a reduction in this, with which the blocking action that they generally produce has an effect on the mesolimbic pathway (positive symptoms such as hallucinations are produced by an excess in this pathway) but in the cortex this blocking effect is reduced and compensated with the inhibition of an inhibitor (the serotonin).

In the case of aripiprazole, this effect occurs in part in some types of serotonin receptors, being blocked by the drug, while on the other hand it stimulates its synthesis as a partial agonist of the receptors 5-HT1a. This contributes to a decrease in the level of dopamine in some areas while generally increasing it in others.

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Indications

The main indication for aripiprazole is the treatment of schizophrenia and other psychotic-type disorders. In this sense contributes to reducing or eliminating positive symptomsEither in the form of hallucinations, agitation or behavioral alterations, at the same time that it has positive effects on the negative (apathy, poverty of thought and affective flattening, among others). It is also used to keep those who suffer from these disorders stable, starting at the age of fifteen.

It has also been used effectively in the treatment of manic episodes in the context of a Bipolar disorder, from thirteen years of age. Not only in the treatment of acute attacks, but also in the prevention of new episodes. However, in some subjects it is possible that the use of this drug triggers manic episodes.

In addition to the above indications, this drug is also sometimes used in the treatment of problems such as Tourette's disorder or autism, usually to control its manifestations clinics.

Side effects

Although very useful in many disorders, aripiprazole is a psychotropic drug that can cause numerous side effects of varying severity.

Among the most frequent we can find the presence of drowsiness and fatigue, weight gain, headache, increased appetite, nervousness, hypersalivation, muscle pain, gastrointestinal disturbances, diarrhea or constipation, and balance problems. Insomnia and anxiety are common. Others more serious would include alterations of consciousness, hyperglycemia, respiratory distress, muscle stiffness, visual disturbances, arrhythmias and dyskinesias, as well as thoughts suicidal. Unlike other antipsychotics, sexual or motor disorders are not frequent.

In addition to this, it has been observed in recent years how the administration of this drug has been associated in some cases (although it is not common) with a increased impulsivity, pathological gambling, hyperphagia, increased libido and the search for sexual relations and the existence of compulsive behaviors such as shopping. In short, it has been associated in some people with the existence of loss of impulse control, something that can have various consequences for the person in question.

Contraindications and risks

Aripiprazole is a very powerful drug that can have various effects in the body, which can pose a considerable risk and is contraindicated in different types of population.

Among those who should not consume this drug we can find those with an allergy to it or to any of its components. This drug is also highly contraindicated by those who suffer from dementia, in these cases increasing the risk of death of the subject. The presence of heart disease or cardiovascular and cerebrovascular diseases they also make this drug contraindicated.

People with diabetes should avoid this drug, since its consumption can raise sugar levels greatly and lead to dangerous hyperglycemia. Those with liver or kidney disease should not use aripiprazole if their condition is severe, or at least they should schedule the doses consumed with the doctor. Also, people with epilepsy are at risk for severe seizures if they take this drug. Another of its contraindications is in pregnant and lactating women, since it increases the risk to the fetus and the drug is transmitted through the placenta and breast milk.

Aripiprazole can interact with different medications, an interaction that can be harmful. Among these drugs we find some of those used in the treatment of HIV, as well as antidepressants, antihypertensive drugs and some anticonvulsants. It should also not be consumed with alcohol or other drugs..

With regard to the loss of impulse control, people who already suffer from a disorder of this type, subjects with substance dependence (whether or not they are already uninhabited), bipolarity (despite being a possible drug to use for treatment) and obsessive disorder compulsive.

Bibliographic references

• Salazar, M.; Peralta, C.; Pastor, J. (2011). Manual of Psychopharmacology. Madrid, Editorial Médica Panamericana.