Tapering Aripiprazole

General Tapering Principles

A decrease of 10% of the original dose per week is a reasonable starting point for tapering aripiprazole, though tapering plans should be individualized based on patient response 1
For patients who have been on aripiprazole for longer durations, slower tapers of 10% per month might be more appropriate and better tolerated 1, 2
Tapers may need to be paused and restarted when the patient is ready, and might need to be slowed once patients reach lower dosages 1
A taper should be considered successful as long as the patient is making progress, even if temporary pauses are needed 1

Monitor for withdrawal symptoms such as anxiety, insomnia, nausea, dizziness, irritability, and tremor after each dose reduction 1, 3
If severe withdrawal symptoms occur, return to the previous well-tolerated dose and slow the taper further 3, 4
Consider adjunctive medications to manage specific withdrawal symptoms, such as short-term sleep aids for insomnia 3 and short-term use of supportive medications for anxiety and irritability 3, 4

More rapid tapers might be needed for patient safety under certain circumstances, such as for patients who have experienced severe adverse events on their current dosage 1

Avoid ultrarapid detoxification, which is associated with substantial risks 1
Discuss with patients the increased risk for relapse on abrupt return to a previously prescribed higher dose 1
Do not use a "one-size-fits-all" approach; tapering schedules need to be adjusted based on individual response 3, 4