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Contraindications and side effects of Aripiprazole

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Discover the contraindications and side effects of Aripiprazole.

This psychoactive drug is part of the group of atypical antipsychotics.

This drug reduces a good part of the psychotic symptoms of various disorders. Pexels.Contraindications and side effects of Aripiprazole

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The suffering of different mental disorders on the part of the population has meant that throughout history different mechanisms and measures have been sought to apply to treat these 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.

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Among them, we find the synthesis of substances that eliminate or reduce symptoms: psychotropic drugs.

About schizophrenia, pharmacological treatment is now considered to be of great importance for the maintenance and stabilization of patients.

And among the many existing psychotropic drugs, we can find aripiprazole, which we are going to talk about in this article.

Aripiprazole: what is it?

Aripiprazole is a psychotropic drug classified as antipsychotic or neuroleptic, drugs specially designed to produce a positive effect in reducing and eliminating the symptoms of schizophrenia and psychotic disorders, such as delusions and hallucinations and psychomotor agitation.

Among the 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 have, as well as increasing the effectiveness in the treatment of a type of symptomatology, negative (those symptoms that reduce the functionality of the skills present in the patient, such as poor thinking and apathy), which typical antipsychotics do not treat or may even harm.

And in this role it is especially efficient, helping to fight both positive and negative symptoms. In addition, it has the advantage of having a possible administration in the form of intramuscular injection in depot format (slow release) every month, 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 this type of neuroleptic, its effects are due to its action on two neurotransmission systems: dopamine and serotonin.

However, its mechanism of action is somewhat different from the rest of the atypical ones when it comes to dopamine.

And it is that 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 a partial agonist of D2 receptors, favoring their presence in the brain in principle. This in principle would allow increasing positive psychotic symptoms, but the truth is that it reduces them.

This reduction is explained by the action of serotonin. The rest of the atypicals decrease brain serotonin in such a way that it stops inhibiting dopamine in areas that do not require a reduction of it, 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 (serotonin).

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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 5-HT1a receptors.

This contributes to a decrease in the level of dopamine in some areas while it is generally increased in others.

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Indications

The main indication for aripiprazole in the treatment of schizophrenia and other psychotic disorders.

In this sense, it contributes to reducing or eliminating positive symptoms, be it in the form of hallucinations, agitation, or behavioral disturbances, as well as having 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 bipolar disorder, starting at the age of thirteen.

Not only in the treatment of acute attacks, but also in the prevention of new episodes. However, in some subjects, the use of this drug may trigger manic episodes.

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

Side effects of Aripiprazole

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 disorders, diarrhea or constipation, and balance problems.

Insomnia and anxiety are common. Other more serious ones would include altered consciousness, hyperglycemia, respiratory distress, muscle stiffness, visual disturbances, arrhythmias, and dyskinesias, as well as suicidal thoughts. 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 an increase in impulsivity, gambling, hyperphagia, increased libido and seeking 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 different consequences for the person in question.

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Contraindications of Aripiprazole

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

Among those who should not consume this drug, we can find those with an allergy to it or 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 also makes 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.

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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. Nor should it be used with alcohol or other drugs.

About 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 inhabited), bipolarity (despite being a possible drug to use for treatment), and obsessive-compulsive disorder

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