Abilify Depot·Psychiatry - Depot Antipsychotics

Aripiprazole LAI

Maintenance treatment of Schizophrenia

Authority requiredPBSDEPOT Q4W/Q8WAbilify Maintena, Abilify AsimtufiiDual-chamber syringe for rec…+2

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At a glance

Max Dose

400 mg Q4W

Half-life

30–46 Days

Caution: Akathisia

MODERATE

Caution: PO Overlap

14 DAYS

Cautions

Avoid / Cautions

Known hypersensitivity. Do not administer IV or SC.

Where it stands

Rapid Summary

Overview

Long-Acting Injectable (LAI) partial D2 agonist. Provides stable, 4-weekly or 8-weekly coverage for schizophrenia with an excellent metabolic profile.

Clinical Focus

Takes weeks to reach steady state. A strict 14-day oral overlap is legally and clinically required upon initiation to prevent psychotic relapse.

Bottom Line

Aripiprazole LAI is a long-acting injectable antipsychotic with low metabolic risk for maintenance schizophrenia treatment, but requires 2 weeks of oral supplementation at initiation and can cause injection site reactions.

Formulation & Access

Brand Names

Abilify Maintena, Abilify Asimtufii

Parenteral

Dual-chamber syringe for reconstitution. Must shake vigorously for 20 seconds immediately before IM injection.

Prescribing & PBS

Authority Required (PBS). Must be initiated by a Psychiatrist.

Indications & Use

Primary

PBSTGA

Maintenance treatment of Schizophrenia.

Clinical Place

Preferred depot for young, metabolically vulnerable patients or those who experienced severe weight gain on Invega/Zyprexa.

Quick reference

Class & Role

Abilify Depot — Long-Acting Injectable (LAI) partial D2 agonist.

Route / Formulation

Dual-chamber syringe for reconstitution. Must shake vigorously for 20 seconds immediately before IM injection. (Abilify Maintena, Abilify Asimtufii)

Usual Dose & Max

IM 400 mg every 4 weeks (Gluteal or Deltoid). Must continue oral Aripiprazole (10-20 mg/day) for 14 consecutive days after the 1st injection. Max 400 mg every 4 weeks (Abilify Maintena).

Key Indication Doses

Abilify Maintena (1-Monthly): IM 400 mg every 4 weeks (Gluteal or Deltoid). Must continue oral Aripiprazole (10-20 mg/day) for 14 consecutive days after the 1st injection. Abilify Asimtufii (2-Monthly): IM 960 mg every 8 weeks (Gluteal ONLY). Missed Dose Rule: If the 2nd or 3rd dose is delayed by > 5 weeks, the patient loses coverage and MUST undergo the 14-day oral overlap again.

Best Uses

Key Risks

Neurological: Akathisia (intense inner restlessness), insomnia. Often requires propranolol to manage. Metabolic: Lowest risk of weight gain, lipid spikes, or hyperprolactinemia among LAIs. Cardiovascular: Minimal QTc or BP effects.

Key Interactions

Strong CYP3A4 inhibitors (Clarithromycin) or CYP2D6 inhibitors (Fluoxetine) require the depot dose to be reduced to 300 mg. Strong CYP inducers (Carbamazepine) will destroy depot blood levels. Avoid combination.

Monitoring

Ensure strict compliance with the 14-day oral overlap. Give the injection deep into the muscle to prevent sterile abscesses. Baseline BSL, Lipids, and Weight.

Clinical Pearl

The suspension settles instantly. If the nurse reconstitutes the syringe, puts it down for 5 minutes to talk to the patient, and then injects it without re-shaking, the needle will block, ruining a $400 injection.

Access

Authority requiredAbilify Maintena, Abilify Asimtufii

Brand: Abilify Maintena, Abilify Asimtufii
PBS status: Authority required

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