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Abilify vs Zyprexa

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Comparative Analysis


For patients with disorders such as schizophrenia, bipolar disorder, or major depressive disorder (MDD), medications that can help manage symptoms and stabilize mood are crucial. Abilify and Zyprexa are two such drugs commonly prescribed for these conditions. They work by affecting various neurotransmitters in the brain associated with mood regulation. Abilify is a partial dopamine agonist and serotonin antagonist, it works by partially activating the brain's dopamine receptors while blocking serotonin receptors to maintain balance. On the other hand, Zyprexa belongs to a class of drugs known as atypical antipsychotics or second-generation antipsychotics (SGAs). It influences multiple neurotransmitters including dopamine, acetylcholine, serotonin, and histamine but prominently acts as an antagonist on specific subtypes of serotonergic and dopaminergic receptors which helps in managing symptoms effectively.

Abilify vs Zyprexa Side By Side

Brand NameAbilifyZyprexa
ContraindicationsShould not be taken if using or have recently used monoamine oxidase (MAO) inhibitors within the last two weeks.Should not be taken if using or have recently used monoamine oxidase (MAO) inhibitors within the last two weeks.
CostFor brand name: around $900 for 30 tablets (10 mg). For generic (Aripiprazole): starts at about $0.60/tablet or roughly between $18-$27/month depending on the prescribed daily dose.For brand name: about $600 for 30 tablets (5 mg). For generic (Olanzapine): starts at just under a dollar and goes up to ~$3 per tablet, depending on quantity and dosage strength.
Generic NameAripiprazoleOlanzapine
Most Serious Side EffectIncreased risk of death in elderly people with dementia-related psychosis, suicidal thoughts or actions in some children, teenagers, and young adults, allergic reactions, neuroleptic malignant syndrome (NMS), uncontrolled body movements (tardive dyskinesia), serotonin syndrome.Signs of an allergic reaction, symptoms suggestive of neuroleptic malignant syndrome, severe nausea and vomiting, yellowing eyes/skin indicative of liver problems, changes in vision, irregular heartbeats, mood swings manifesting as suicidal thoughts or increased aggression towards others.
Severe Drug InteractionsMAO inhibitors.MAO inhibitors.
Typical DoseOral dosages range from 2-30 mg/day, with a starting dose of 10 or 15 mg/day usually effective for treating schizophrenia and bipolar disorder in adults.Treatment typically initiated at a dosage of 5–10 mg/day, can be increased to 20 mg/day.

What is Abilify?

Aripiprazole (the generic name for Abilify) and Olanzapine (Zyprexa) are two atypical antipsychotics that have played a significant role in treating various psychiatric disorders since their inception. Aripiprazole, first approved by the FDA in 2002, works uniquely by balancing levels of dopamine and serotonin, effectively leading to reduced symptoms of certain mental conditions. It has been prescribed widely for schizophrenia, bipolar disorder, depression augmentation, and autism-related irritability.

In contrast to Abilify's dopamine-serotonin activity modulation mechanism, Zyprexa primarily works as an antagonist on different neurotransmitters like dopamine D2 receptors and serotonin 5-HT2 receptors. Hence it is also used more broadly across various psychotic disorders but can potentially lead to more severe metabolic side effects than those seen with Abilify. Therefore while choosing between these two medications one must weigh their efficacy against potential side effect profiles.

What conditions is Abilify approved to treat?

Abilify is approved for the treatment of various mental health disorders, which include:

  • Schizophrenia
  • Bipolar I disorder (manic and mixed episodes)
  • Major depressive disorder (as an adjunct to antidepressants)
  • Irritability associated with autistic disorder in pediatric patients
  • Tourette's Disorder in pediatric patients.

How does Abilify help with these illnesses?

Abilify works to manage symptoms of psychiatric conditions like schizophrenia and bipolar disorder by balancing the levels of dopamine and serotonin in the brain. It does this by selectively blocking or activating their receptors depending on the current levels, thus acting as a stabilizer. Dopamine and serotonin are neurotransmitters that play crucial roles in mood regulation, cognition, reward processing, sleep patterns among other things. In individuals with conditions like schizophrenia or bipolar disorder, these chemicals can become imbalanced leading to a variety of symptoms including hallucinations, delusions or mood swings. By regulating dopamine and serotonin activity, Abilify helps limit these negative effects and aids patients in managing their condition more effectively.

What is Zyprexa?

Zyprexa, also known as olanzapine, is an atypical antipsychotic, which means it modulates the levels of various neurotransmitters in the brain including dopamine and serotonin. Like other drugs in its class, Zyprexa does not solely block dopamine receptors but acts on a range of neurotransmitter systems. It was first approved by the FDA in 1996.

Because Zyprexa modulates several different types of receptors (including serotonergic, dopaminergic, adrenergic and histaminergic ones), its side-effect profile can be quite diverse compared to typical antipsychotics. This includes potential weight gain and metabolic changes such as elevated blood sugar levels—common issues with atypical antipsychotics like Abilify. However, because it has less tendency to cause extrapyramidal symptoms (movement disorders often caused by typical antipsychotics), many patients may find Zyprexa more tolerable than older generation medications. Its broad action across multiple neurotransmitter systems can be beneficial for treating conditions such as schizophrenia and bipolar disorder especially when patients do not respond well to "typical" antipsychotic drugs.

What conditions is Zyprexa approved to treat?

Zyprexa is approved for the treatment of several serious mental health disorders, including:

  • Schizophrenia
  • Bipolar I disorder (manic or mixed episodes and maintenance)
  • Treatment-resistant depression as part of a combination therapy.

How does Zyprexa help with these illnesses?

Dopamine is a neurotransmitter that plays several important roles in the brain and body, including regulation of mood, motivation, reward, and attention. Additionally, it contributes to the "fight or flight" response initiated during stressful situations. In conditions such as schizophrenia or bipolar disorder where dopamine activity may be abnormal, medications like Zyprexa can help manage symptoms by balancing this neurotransmitter's activity. Specifically, Zyprexa works by blocking certain dopamine receptors in the brain which can decrease hallucinations and improve concentration. Unlike Abilify which also affects serotonin levels significantly and acts as a partial agonist at dopamine receptors (meaning it both stimulates and reduces its activity), Zyprexa primarily inhibits certain types of dopamine receptors leading to a more calming effect on the nervous system. This makes Zyprexa potentially more suitable for patients who experience agitation or restlessness with other antipsychotic drugs.

How effective are both Abilify and Zyprexa?

Both aripiprazole (Abilify) and olanzapine (Zyprexa) have robust histories of efficacy in managing symptoms of psychological disorders such as bipolar disorder, schizophrenia, and major depressive disorder. Approved by the FDA only several years apart, they operate on different neurotransmitter systems which may necessitate their prescription under varying circumstances. A direct study in a 2007 double-blind clinical trial demonstrated similar effectiveness between Abilify and Zyprexa in managing psychosis-related symptoms, with both drugs presenting promising safety profiles. Within this study, no significant differences were observed in the measures used to gauge treatment efficacy for psychosis between patients receiving Abilify or Zyprexa.

A review from 2014 showed that Abilify is effective at reducing symptoms of depression when it starts working within the first one to two weeks of treatment. Its side effect profile is considered favorable compared to many other antipsychotics due to its unique mechanism as a partial agonist at dopamine D2 receptors - providing just enough stimulation without overstimulating these receptors like traditional antipsychotics can do. This property has led it to become one of the most widely prescribed antipsychotic medications globally.

According to a meta-analysis conducted in 2016, Olanzapine appears more effective than placebo treatments for addressing psychotic symptoms and manic episodes associated with bipolar disorder - showing comparable efficacy rates with other typical antipsychotics along with notable weight gain side effects. However, Olanzapine's use typically comes after failed trials or intolerable side effects experienced from first-line therapies due its pronounced potential for metabolic disturbances including weight gain – leading some clinicians consider it as second- or third-line option.

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At what dose is Abilify typically prescribed?

Oral dosages of Abilify range from 2-30 mg/day, but research has indicated that a starting dose of 10 or 15 mg/day is usually effective for treating schizophrenia and bipolar disorder in adults. Children and adolescents aged 13-17 may be started on 2 mg/day. Dosage can be increased after a few weeks if there is no response. On the other hand, oral dosages for Zyprexa range from 5-20mg per day with an initial dose of about 10mg daily being common. This dosage also applies to teenagers age between 13 to17 years old who have schizophrenia or bipolar disorder. As always, it's important not to exceed the maximum recommended dosage without consulting your healthcare provider.

At what dose is Zyprexa typically prescribed?

Zyprexa treatment is typically initiated at a dosage of 5–10 mg/day. The dose can subsequently be increased to 20 mg/day, divided into one or two doses that should be taken at different times during the day. The maximum recommended daily dose for Zyprexa is 20mg, which may be adjusted if there is no significant response to the treatment after several weeks. As with any medication, it's important that changes in dosages are done under supervision from your healthcare provider as they will carefully assess and monitor your symptoms and side effects.

What are the most common side effects for Abilify?

The most common side effects of Abilify and Zyprexa, two antipsychotic medications, can vary:

Abilify's potential side effects include:

  • Weight gain
  • Headache
  • Anxiety
  • Insomnia or excessive sleepiness (somnolence)
  • Restlessness or need to keep moving (akathisia)
  • Nausea, vomiting, constipation
  • Increased salivation

Zyprexa may cause the following side effects:

  • Drowsiness/sleepiness (somnolence)
  • Dizziness
  • Unusual tiredness or weakness
  • Tremor (unintentional trembling or shaking)
  • Dry mouth -Nausea, upset stomach, constipation. -Increased appetite and subsequent weight gain. -Akathisia: feeling restless and unable to sit still.

It is important to note that each individual may experience a unique set of side effects based on their body's reaction to the medication. Always consult with your healthcare provider if you notice any new symptoms while taking these medications.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Abilify?

While both Abilify and Zyprexa are antipsychotics used to treat conditions such as schizophrenia and bipolar disorder, they can have different side effects. Some potential serious side effects of these medications include:

  • Increased risk of death in elderly people with dementia-related psychosis
  • Suicidal thoughts or actions in some children, teenagers, and young adults
  • Allergic reactions: hives; difficult breathing; swelling of your face, lips, tongue or throat
  • Neuroleptic malignant syndrome (NMS), a potentially fatal symptom complex has been reported: high fever, stiff muscles, confusion, sweating more than usual; fast or irregular heartbeat; feeling like you might pass out.
  • Uncontrolled body movements (tardive dyskinesia) which may become permanent: muscle stiffness (rigidity), twitching or uncontrollable movement; loss of balance control; trouble speaking or swallowing. Serotonin syndrome - agitation hallucinations coma extreme changes in blood pressure increased heart rate fever excessive sweating shivering/shaking nausea vomiting diarrhea muscle crampiness.

If you experience any severe symptoms mentioned above while taking Abilify or Zyprexa, seek medical help immediately.

What are the most common side effects for Zyprexa?

In comparison to Abilify, Zyprexa can cause an array of side effects. These may include:

  • Dry mouth and increased salivation
  • Nasal congestion
  • Vision changes such as blurred vision
  • Nausea, vomiting, stomach discomfort or constipation
  • Difficulty sleeping (insomnia)
  • Uncontrollable movements, shaking or a feeling of restlessness
  • Elevated heart rate
  • Cognitive disturbances leading to confusion or agitation
  • Possible skin rash or sensitivity reactions
  • Weight gain rather than weight loss is more commonly associated with Zyprexa use -Difficulty urinating could be experienced in some patients
    -Potential for headache and dizziness -Muscular stiffness and joint pain.

Always keep in mind that individual responses to medication will vary; not every patient will experience all these side effects.

Are there any potential serious side effects for Zyprexa?

Zyprexa, though generally considered safe and effective for treating certain mental/mood conditions, can in rare cases cause serious side effects. These may include:

  • Signs of an allergic reaction such as rash, itching or hives on the skin; shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue or other parts of the body
  • Symptoms suggestive of neuroleptic malignant syndrome like high fever, stiff muscles, confusion or loss of consciousness
  • Severe nausea and vomiting
  • Yellowing eyes/skin indicative of liver problems
  • Changes in vision including blurred vision and eye pain
  • Irregular heartbeats
  • Mood swings manifesting as suicidal thoughts or increased aggression towards others.

If you experience any unusual symptoms while taking Zyprexa it is important to seek immediate medical advice.

Contraindications for Abilify and Zyprexa?

Both Abilify and Zyprexa, as with many antipsychotic medications, may potentially worsen symptoms of depression in some individuals. If you notice your mental health declining or an increase in suicidal ideation, thoughts or behavior while on these medications, please seek immediate medical help.

Neither Abilify nor Zyprexa should be taken if you are using or have recently used monoamine oxidase (MAO) inhibitors within the last two weeks. Please always inform your physician about all the medications you are currently taking; MAOIs will require a period of approximately 14 days to clear from your system to prevent dangerous interactions with both Abilify and Zyprexa.

How much do Abilify and Zyprexa cost?

For the brand name versions of these drugs:

  • The price of 30 tablets of Abilify (10 mg) averages around $900, which works out to $30/day based on a daily dose.
  • The price of 30 tablets Zyprexa (5 mg) averages about $600, working out to approximately $20/day.

Thus, if you are taking similar doses for both medications, then brand-name Zyprexa is less expensive on a per-day treatment basis. However, remember that cost should not be your primary consideration in determining which medicine is right for you.

For the generic versions of these medicines:

  • Aripiprazole (generic Abilify), usually available in packs starting from 15 up to 500 tablets with varying dosages from 2–30mg each tablet prices can range significantly. For example,a typical dosage like a pack containing 2mg/tablet may start at about $0.60/tablet or roughly between$18-$27/month depending upon your prescribed daily dose.

  • Olanzapine (generic Zyprexa), typically comes in packs ranging from as low as 7 up to quantities over hundreds with dosages varying between 2.5 –20 mg starts at just under a dollar and goes upto ~$3 per tablet again highly dependent on quantity and dosage strength bought upfront; making it slightly more expensive than its counterpart above but still significantly cheaper compared to their respective brand names.

Popularity of Abilify and Zyprexa

Aripiprazole, also known under the brand name Abilify, was prescribed to approximately 7.3 million people in the United States in 2020. Aripiprazole accounted for about 16% of atypical antipsychotic prescriptions in the US and stands as one of the most commonly used treatments for a variety of psychiatric conditions such as schizophrenia and bipolar disorder.

Olanzapine, commercially known as Zyprexa, had about 2.8 million prescriptions filled within that same year in the USA. In terms of prescription volume amongst atypical antipsychotics, olanzapine represents roughly 6% but has been slightly declining over recent years due to concerns regarding metabolic side effects.

Both medications fall into a class called "atypical" antipsychotics which have become increasingly popular due to their improved safety profiles compared to older "typical" antipsychotics.


Both Abilify (aripiprazole) and Zyprexa (olanzapine) have extensive records of usage in patients with conditions such as schizophrenia, bipolar disorder, and major depressive disorders. They are backed by numerous clinical studies indicating their effectiveness compared to placebo treatments. Although both drugs can be used together under the careful guidance of a doctor, they do interact with each other and this combination should only be considered when other treatment options have proven ineffective.

Abilify primarily acts on dopamine receptors but also has some activity at serotonin receptors, while Zyprexa mainly works by blocking specific types of serotonin and dopamine receptors. This difference in mechanism leads to them being prescribed under different circumstances - Abilify is often used as an add-on treatment for depression when first-line antidepressants aren't fully effective or cause side effects.

Both medications are available in generic form which represents significant cost savings especially for patients who must pay out of pocket. Both Abilify and Zyprexa may require an adjustment period before noticeable effects occur.

The side effect profile differs between the two drugs; although generally well-tolerated, Zyprexa is more likely than Abilify to cause weight gain and metabolic changes such as increased cholesterol levels or blood sugar levels. Patients using either drug should closely monitor their symptoms particularly during the initial phase of therapy, reporting any worsening mental health symptoms or unusual physical changes immediately.