Prescription ·Strong evidence ·Reviewed May 2026
Prescription second-generation (atypical) antipsychotic approved for schizophrenia, bipolar I disorder, adjunctive treatment for major depressive disorder, irritability associated with autistic disorder, and Tourette's disorder. Unique among antipsychotics as a dopamine D2 partial agonist, providing a more balanced dopaminergic modulation with a lower risk of metabolic side effects and extrapyramidal symptoms. Dosage must be determined by your prescribing physician.
The bottom line
Evidence rating strong. Most-documented uses: psychotic symptom reduction, bipolar mood stabilization, adjunctive depression treatment. 11 sources indexed (2009–2024), with 2 interaction records on file.
Core mechanism
Acts as a partial agonist at dopamine D2 and serotonin 5-HT1A receptors, and as an antagonist at serotonin 5-HT2A receptors. As a D2 partial agonist, it stabilizes dopamine activity, reducing excessive dopamine transmission in mesolimbic pathways (antipsychotic effect) while preserving dopamine function in mesocortical and nigrostriatal pathways (fewer cognitive and motor side effects).
Can be taken with or without food. Long-acting injectable formulations (Abilify Maintena, Aristada) available for monthly or every-2-month dosing.
St. John's Wort induces CYP3A4 and CYP2D6, both of which metabolize aripiprazole. This can reduce aripiprazole levels by 50% or more, potentially causing psychotic relapse.
Recommendation: Avoid St. John's Wort with aripiprazole. The FDA prescribing information lists strong CYP3A4 inducers as requiring dose adjustment.
THC-dominant cannabis can work against the treatment goals of aripiprazole in psychosis or bipolar disorder. Continued cannabis use after a psychotic episode is linked with higher relapse rates, poorer adherence, and more antipsychotic treatment failure. Risk is highest with daily use, high-potency THC products, prior cannabis-induced psychosis, or recent hospitalization.
Recommendation: Avoid THC-dominant cannabis while taking aripiprazole for psychosis or mood stabilization. If you are already using cannabis, tell your prescriber because relapse risk and medication adherence need closer monitoring. Separating the timing of cannabis and aripiprazole does not remove this risk.
Numbered references. Citations throughout the page link here.
Kishi T, Sakuma K, Saito T et al.. Comparison of brexpiprazole, aripiprazole, and placebo for Japanese major depressive disorder: A systematic review and network meta-analysis. Neuropsychopharmacology reports. 2024
Akbari M, Jamshidi S, Sheikhi S et al.. Aripiprazole and its adverse effects in the form of impulsive-compulsive behaviors: A systematic review of case reports. Psychopharmacology. 2024
de Brabander E, Kleine Schaars K, van Amelsvoort T et al.. Influence of CYP2C19 and CYP2D6 on side effects of aripiprazole and risperidone: A systematic review. Journal of psychiatric research. 2024
Valdivieso-Jiménez G, Pino-Zavaleta DA, Campos-Rodriguez SK et al.. Efficacy and Safety of Aripiprazole in Borderline Personality Disorder: A Systematic Review. The Psychiatric quarterly. 2023
Miola A, Salvati B, Sambataro F et al.. Aripiprazole for the treatment of delusional disorders: A systematic review. General hospital psychiatry. 2020
Britnell SR, Jackson AD, Brown JN et al.. Aripiprazole for Post-traumatic Stress Disorder: A Systematic Review. Clinical neuropharmacology. 2017
Pae CU. A review of the safety and tolerability of aripiprazole. Expert opinion on drug safety. 2009
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