Q. Is Aripiprazole safe for my father who is 65 years old?

Answered by
Dr. Vivek Chail
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Aug 08, 2015 and last reviewed on: Jan 23, 2019

Hello doctor,

My father is 65 years old. He has bipolar disorder for 40 years. He also has diabetes. He is taking medicine for high blood pressure.

For a very long time, he took lithium 1000 mg and oxcarbazepine 900 mg. 2-3 episodes used to happen, normally of long manic spell followed by gloomy/not so active spell. He stopped lithium due to toxicity, as even low dose was toxic. He started 200 mg quetiapine at night. In manic spell, he used to take up to 30 mg aripiprazole for 2-3 months.

Considering his age and other medical conditions, what should be the right combination of medicine? Is aripiprazole safe? (it is very effective in mania for him) Now he has stopped aripiprazole, and he is fine. But he is complaining of restlessness sometimes. He feels like not wanting to sit in a place. What should be given to him in this post mania phase? Please ask for any more details if you require.



Welcome to icliniq.com.

I have read through your query in detail. Please find my observations below.

Medicines for mental health conditions should be taken under the strict supervision of the psychiatrist. As mentioned above, lithium toxicity is a serious concern and it is good that you have stopped lithium due to toxicity.

Quetiapine is an atypical antipsychotic medication and studies have shown that it is a safe and effective medication for the elderly. The side effects are less when the patient takes Quetiapine.

Transient hypotension, dizziness, and somnolence are the only side effects in patients and is seen rarely. Long term use of Quetiapine has shown no serious side effects in the elderly.

Aripiprazole is good medicine but might cause agitation and activation in about 8 percent of elderly people who take it. Studies show that in most patients Aripiprazole can be continued at a dose of 10 to 15 mg/day. Aripiprazole has less metabolic side effects than other medicines.

Side effects of Aripiprazole include dizziness, weakness, lightheadedness, nausea, vomiting, stomach upset, tiredness, excess saliva or drooling, choking or trouble in swallowing, blurred vision, headache, anxiety, weight gain, drowsiness, sleep problems (insomnia) and constipation.

There is a little increase in the risk of stroke in the elderly due to the intake of antipsychotic medicines, though this is very less. It is very important to go into details of patient problems when prescribing and changing doses of medicines.

I hope your father is managing well with his diabetes and blood pressure.

Considering the above, it is best to prescribe medicines based on benefit and risk. Some patients might do well without medicine without much bipolar symptoms and in the absence of frequent attacks, however many require medicines like your father.

There is no fixed regimen over one medicine being better than the rest but medicine like Aripiprazole has fewer side effects.

Can you please let us know the treatment he has undertaken in the last 2 years, including medicine name and duration for which it was taken, dose, symptoms, and improvements.

Thanks a lot doctor.

In addition to the above information, I forgot to mention that in manic phase he also takes 2 mg of Rivotril for sleep. In the past 2 years his health is more or less the same.



Welcome back to icliniq.com.

1. Please change the medications only under the recommendation of the treating psychiatrist and after clinical evaluation. The following are only suggestions based on information given by you. Patients with diabetes and hypertension have a limited choice of antipsychotic medications and require medications to be taken on an individual basis.2. Oxcarbazepine is a good alternative to lithium. However, if he is taking Quetiapine, then that is better.3. Right now:

  1. Either Quetiapine or Aripiprazole (anyone medicine and not both) requires to be given although he is in post mania. If nothing is given, then there is a higher chance of relapse.
  2. Rivotril (Clonazepam) might be given in split doses, 0.25 mg in the morning and 0.5 mg at night for restlessness and disturbed sleep. 2 mg is a slightly higher dose and is usually given only if patients develop tolerance. This has to be taken for 2 weeks and subsequently tapered and terminated. This is because few elderly patients might have side effects with long term use of Rivotril.

Was this answer helpful?


Related Questions:
Do my symptoms indicate bipolar disorder or schizophrenia?

To me, it seems more closely related to schizophrenia or schizoaffective disorder ... Schizophrenia and schizoaffective disorder diagnosis are made only when there are criterias of disease w...   Read full

Mirap and Clonazepam prescribed for anxiety and depression, Is it fine to take?

Age 40Y, Male, minor knee pain sometime ,TAK Tak Sound when sit on kness, no injury , Family Heridatory , suggest precaution in diet or medicine for future   Read full

Taking medicines for bipolar disorder, but unable to sleep. Is there any suggestions?

When i go to the toilet i pass my stool and then when i wipe there is blood on the tissue   Read full


This is a sponsored Ad. icliniq or icliniq doctors do not endorse the content in the Ad.

Also Read Answers From:

Comprehensive Medical Second Opinion.Submit your Case

Related Questions & Answers

What are the drugs incompatible with Quetiapine and Lamotrigine?

Query: Hi doctor, My query is regarding the incompatibility of Quetiapine and Lamotrigine with other groups of drugs. Now I have to get treatment for an anaerobic infection. I was prescribed Azithromycin, Clindamycin, Metronidazole and Mycomax. However, I will be extremely grateful if you list me all grou...  Read Full »

To stop continuous panic attacks, which drug can be taken other than Clonazepam?

Query: Hi doctor, I have been on Klonopin that is Clonazepam prescribed before 14 years for panic attacks and anxiety. I am currently on the 2 mg dosage and taking it four times a day. This is monitored every few months by my family doctor. For the past one week, I have noticed that I have been experienc...  Read Full »

What medicine should I avoid while taking Lithium and Quetiapine?

Query: Hi doctor, I am on Lithium 600 mg per day and Quetiapine 300 mg per day. I would like to know what kind of food, beverages and medicines I should avoid.  Read Full »

Also Read

Sinusitis - Causes, Symptoms and Treatment
Sinusitis is the infection of the air cavities within the nasal passages. Normally, the healthy sinuses are filled with ...  Read more»
Asthma and Its Rising Incidence
This article explains about asthma and its causes. It also focuses on the benefits of starting early treatment to lead a...  Read more»
Parkinson's Disease: Historical Aspects and Current Treatment Approaches
This article discusses the historical aspects of Parkinsonism and, the evidence based approaches currently available for...  Read more»

Ask your health query to a doctor online?

Ask a Geriatrician Now

* guaranteed answer within 4 hours.

Disclaimer: All health Q&As content published on this website are not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek the advice from your physician or other qualified health-care providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.