Abilify Vs. Lexapro: Drug Comparison

Abilify^® (aripiprazole) is an atypical antipsychotic medication used to treat conditions such as schizophrenia, bipolar disorder, and as an adjunct for major depressive disorder. FDA-approved indications include schizophrenia in adults and adolescents, bipolar I disorder, and as an add-on treatment for depression. Additional uses include treating irritability in autism, borderline personality disorder, and Tourette syndrome. Abilify is available in various forms, including tablets, orally disintegrating tablets, solutions, and injections. Common side effects include akathisia (movements such as fidgeting), weight gain, dizziness, and nausea, while serious warnings include a boxed warning for increased risk of suicidal thoughts in children, adolescents, and young adults, as well as potential drug interactions.

Lexapro^® (escitalopram) is a selective serotonin reuptake inhibitor (SSRI) used to treat anxiety and depression by increasing available serotonin levels in the brain, which helps improve mood and reduce anxiety. Its FDA-approved indications include the treatment of major depressive disorder (MDD) and generalized anxiety disorder (GAD) in adults and adolescents. Off-label uses may include treating panic disorder, obsessive-compulsive disorder (OCD), and social anxiety disorder. Lexapro is available in tablet and oral solution forms, taken once daily. Common side effects include nausea, insomnia, and sexual dysfunction, and it carries a boxed warning for an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults, particularly during the initial stages of treatment.

Atypical antipsychotic

Selective serotonin reuptake inhibitor (SSRI)

Abilify (aripiprazole) is indicated for:

• Schizophrenia

• Acute treatment of manic and mixed episodes associated with bipolar I disorder

• Adjunctive treatment of major depressive disorder

• Irritability associated with autistic disorder

• Treatment of Tourette disorder

Lexapro (escitalopram) is indicated for the:

• Treatment of major depressive disorder (MDD) in adults and pediatric patients 12 years of age and older

• Treatment of generalized anxiety disorder (GAD) in adults and pediatric patients 7 years and older

• Typically taken orally once daily

• Comes in 2 mg, 5 mg, 10 mg, 15 mg, 20 mg, and 30 mg tablets

• Typically taken orally once daily

• Comes in 5 mg, 10 mg (scored), and 20 mg (scored) tablets

Commonly observed adverse reactions (incidence ≥5% and at least twice that for placebo) were:

Adult patients with schizophrenia:

• Inability to remain still

Pediatric patients (13 to 17 years) with schizophrenia:

• Movement disorders

• Sleepiness

• Tremor

Adult patients (monotherapy) with bipolar mania:

• Inability to remain still

• Sedation

• Restlessness

• Tremor

• Movement disorders

Adult patients (adjunctive therapy with lithium or valproate) with bipolar mania:

• Inability to remain still

• Insomnia

• Movement disorders

Pediatric patients (10 to 17 years) with bipolar mania:

• Sleepiness

• Movement disorders

• Fatigue

• Nausea

• Inability to remain still

• Blurred vision

• Overproduction of saliva

• Dizziness

Adult patients with major depressive disorder (adjunctive treatment to antidepressant therapy):

• Inability to remain still

• Restlessness

• Insomnia

• Constipation

• Fatigue

• Blurred vision

Pediatric patients (6 to 17 years) with autistic disorder:

• Sedation

• Fatigue

• Vomiting

• Sleepiness

• Tremor

• Fever

• Drooling

• Decreased appetite

• Overproduction of saliva

• Movement disorders

• Lethargy

Pediatric patients (6 to 18 years) with Tourette's Disorder:

• Sedation

• Sleepiness

• Nausea

• Headache

• Inflammation of the nose and throat

• Fatigue

• Increased appetite

Most commonly observed adverse reactions (incidence ≥ 5% and at least twice the incidence of placebo patients) are:

• Insomnia

• Ejaculation disorder (primarily ejaculatory delay),

• Nausea

• Sweating increased

• Fatigue and sleepiness

• Decreased libido

• Inability to orgasm

• Known hypersensitivity to Abilify

• Drug interactions: Dosage adjustments for certain drug interactions

• Do not use MAOIs intended to treat psychiatric disorders with Lexapro or within 14 days of stopping treatment with Lexapro. Do not use Lexapro within 14 days of stopping an MAOI intended to treat psychiatric disorders. In addition, do not start Lexapro in a patient who is being treated with linezolid or intravenous methylene blue

• Concomitant use of pimozide

• Known hypersensitivity to escitalopram or citalopram or any of the inactive ingredients

• Drug interactions: SSRIs, SNRIs, tryptophan, drugs that affect hemostasis (NSAIDs, aspirin, warfarin)

• Cerebrovascular adverse reactions in elderly patients with dementia-related psychosis

• Neuroleptic malignant syndrome

• Tardive dyskinesia

• Metabolic changes: Atypical antipsychotic drugs have been associated with metabolic changes that include hyperglycemia/diabetes mellitus, dyslipidemia, and body weight gain

• Pathological gambling and other compulsive behaviors

• Orthostatic hypotension

• Leukopenia, neutropenia, and agranulocytosis

• Seizures/Convulsions

• Potential for cognitive and motor impairment

• Suicide: The possibility of a suicide attempt is inherent in schizophrenia and bipolar disorder

• Pregnancy: May cause extrapyramidal and/or withdrawal symptoms in neonates with third trimester exposure

• Serotonin syndrome

• Discontinuation syndrome

• Seizures

• Activation of mania/hypomania

• Low blood sodium: Can occur in association with syndrome of inappropriate antidiuretic hormone secretion

• Increased risk of bleeding

• Interference with cognitive and motor performance

• Angle closure glaucoma

• Use in patients with concomitant illness

• Sexual dysfunction

• Pregnancy: SSRI use, particularly later in pregnancy, may increase the risk for persistent pulmonary hypertension and symptoms of poor adaptation (respiratory distress, temperature instability, feeding difficulties, hypotonia, tremor, irritability) in the neonate

WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS and SUICIDAL THOUGHTS AND BEHAVIORS WITH ANTIDEPRESSANT DRUGS

Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Abilify is not approved for the treatment of patients with dementia-related psychosis.

Increased risk of suicidal thinking and behavior in children, adolescents, and young adults taking antidepressants. Monitor for worsening and emergence of suicidal thoughts and behaviors.

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Increased risk of suicidal thoughts and behavior in pediatric and young adult patients taking antidepressants. Closely monitor all antidepressant-treated patients for clinical worsening and emergence of suicidal thoughts and behaviors. Lexapro is not approved for use in pediatric patients less than 7 years of age.

*This information is from the label for brand name Abilify^®. See the Full Prescribing Information for more complete information. Aripiprazole, the active ingredient in Abilify, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient aripiprazole.

*This information is from the label for brand name Lexapro^®. See the Full Prescribing Information for more complete information. Escitalopram, the active ingredient in Lexapro, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient escitalopram.