Aripiprazole withdrawal symptoms
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Aripiprazole Withdrawal Symptoms: Overview and Key Findings
Aripiprazole is a commonly used atypical antipsychotic, but its withdrawal symptoms are not as well documented as those of other antipsychotics. However, available reports and case studies provide insight into the types of symptoms that may occur when discontinuing aripiprazole, especially if stopped abruptly.
Types of Aripiprazole Withdrawal Symptoms
Movement Disorders and Dyskinesia
Withdrawal from aripiprazole can lead to abnormal movement disorders, such as dyskinesia. This has been observed in both adults and children. For example, a case report described a child developing oral dyskinesia (involuntary mouth movements) after stopping aripiprazole, which resolved after restarting the medication and gradually disappeared over time after dose reduction. These withdrawal-related movement symptoms are considered self-limited but can impact quality of life, especially in children, and may be underreported or mistaken for other conditions like akathisia or ADHD symptoms 21.
Mixed Withdrawal Symptoms
Some individuals experience a range of mixed symptoms after stopping aripiprazole. These can include:
- Nausea
- Lightheadedness
- Tachycardia (rapid heartbeat)
- Diaphoresis (sweating)
- Anxiety
- Insomnia
- Headaches
- Tremulousness (shaking)
- Flu-like symptoms
- Muscle twitching
- Irritability
- Dysphoria (unease or dissatisfaction) These symptoms typically begin within a few days of stopping the medication and may last for up to two weeks, gradually improving over time. Some symptoms, such as insomnia, irritability, and dysphoria, may overlap with a relapse of the underlying psychiatric condition, but others (like nausea and muscle twitching) are more suggestive of withdrawal itself .
Supersensitivity Psychosis
Although more commonly reported with other antipsychotics, abrupt discontinuation of aripiprazole may theoretically lead to withdrawal supersensitivity psychosis, where psychotic symptoms rapidly return or worsen. However, direct reports of this specific phenomenon with aripiprazole are limited .
Prevalence and Recognition
There are few large-scale studies on the prevalence of aripiprazole withdrawal symptoms, especially in children. Most information comes from case reports and anecdotal evidence. Some symptoms may be underrecognized or misattributed to other causes, leading to underreporting 21.
Clinical Considerations and Recommendations
Given the potential for withdrawal symptoms, it is important for clinicians to:
- Taper aripiprazole gradually rather than stopping abruptly, especially in children and those with a history of movement disorders.
- Monitor for both physical and psychological symptoms after discontinuation.
- Distinguish between withdrawal symptoms and relapse of the underlying psychiatric disorder 21.
Conclusion
While aripiprazole withdrawal symptoms are not as well characterized as those of other antipsychotics, evidence suggests that abrupt discontinuation can lead to movement disorders, mixed physical and psychological symptoms, and possibly psychotic relapse. These symptoms are usually self-limited but can be distressing. Gradual tapering and careful monitoring are recommended to minimize withdrawal effects and ensure patient safety 21.
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