Abilify Vs. Zoloft: 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.

Zoloft^® (sertraline) is a selective serotonin reuptake inhibitor (SSRI) used to treat mood disorders by increasing available serotonin levels in the brain, which helps improve mood and reduce symptoms of anxiety and depression. Its FDA-approved indications include the treatment of major depressive disorder (MDD), obsessive-compulsive disorder (OCD), panic disorder (PD), post-traumatic stress disorder (PTSD), social anxiety disorder (SAD), and premenstrual dysphoric disorder (PMDD). Off-label uses may include the treatment of eating disorders and generalized anxiety disorder (GAD). Zoloft is available in tablet and oral solution forms, typically taken once daily. Common side effects include nausea, dizziness, 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 treatment period.

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

Zoloft (sertraline hydrochloride) is indicated for the treatment of:

• Major depressive disorder (MDD)

• Obsessive-compulsive disorder (OCD)

• Panic disorder (PD)

• Posttraumatic stress disorder (PTSD)

• Social anxiety disorder (SAD)

• Premenstrual dysphoric disorder (PMDD)

• 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 25 mg, 50 mg, and 100 mg tablets and 20 mg/mL oral solution

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 common adverse reactions (≥5% and twice placebo) in pooled placebo-controlled MDD, OCD, PD, PTSD, SAD and PMDD clinical trials were:

• Nausea

• Diarrhea/Loose stool

• Tremor

• Indigestion

• Decreased appetite

• Excessive sweating

• Ejaculation failure

• Decreased libido

• Known hypersensitivity to Abilify

• Drug interactions: Dosage adjustments for certain drug interactions

• Concomitant use of monoamine oxidase inhibitors (MAOIs), or use within 14 days of stopping MAOIs

• Concomitant use of pimozide

• Known hypersensitivity to sertraline or excipients

• Zoloft oral solution only: Concomitant use of disulfiram

• Drug interactions: protein-bound drugs, CYP2D6 substrates

• 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

• Increased risk of bleeding

• Activation of mania/hypomania

• Seizures

• Angle closure glaucoma

• QTc prolongation

• Sexual dysfunction

• Pregnancy: Third trimester use may increase risk for persistent pulmonary hypertension and withdrawal 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

Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients.

Closely monitor for clinical worsening and emergence of suicidal thoughts and behaviors.

*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 Zoloft^®. See the Full Prescribing Information for more complete information. Sertraline, the active ingredient in Zoloft, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient sertraline.