Antipsychotic medications such as Abilify might be helpful for OCD when other treatments haven’t improved symptoms.

Living with obsessive-compulsive disorder (OCD) might have you grasping at straws for help if the first or second treatment doesn’t work.

Treatment for OCD often involves a combination of medication and therapy. Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) are the most commonly used for OCD, but there are other options you can try to help manage your symptoms.

Though not usually a first choice, the antipsychotic Abilify may be helpful in some cases.

Abilify (generic name: aripiprazole) is an atypical, or second-generation, antipsychotic medication.

Antipsychotic medications help manage moods by affecting the neurotransmitters in the brain, particularly dopamine and serotonin.

There are two types of antipsychotic medications: typical (first-generation) and atypical (second-generation). Typical antipsychotics work by affecting primarily the dopamine receptors.

Atypical antipsychotics such as Abilify influence both dopamine and serotonin receptors to restore their balance, which can help improve mood, thinking, and behavior.

Abilify is typically used along with selective serotonin reuptake inhibitors (SSRIs) or other OCD medicines. SSRIs generally are the first-line treatment for OCD.

Research from 2014 reported about 40%-60% of those living with OCD don’t see enough improvement when taking SSRIs alone. That’s where Abilify may be able to help.

A 2019 study suggests that aripiprazole and risperidone (Risperdal) are the most proven effective antipsychotic medications when used with other medications in treating OCD.

Aripiprazole was found to be effective when added as an adjunct medication to an SSRI when there’s been only partial improvement with other treatments, according to research from 2019.

Most medications can cause possible side effects. These can be mild or serious.

Mild side effects you may experience when taking Abilify include:

  • headache
  • drowsiness
  • restlessness
  • fatigue (lack of energy)
  • difficulty sleeping (insomnia)
  • anxiety
  • fluctuations in weight (gain or loss)
  • nausea, vomiting, or constipation
  • dizziness

Some serious side effects of Abilify include:

  • uncontrollable or involuntary movements (such as tremors)
  • metabolism changes (such as high blood sugar or high cholesterol)
  • difficulty swallowing
  • trouble concentrating or thinking clearly

Side effects typically lessen in a couple of days or a few weeks after your body has become accustomed to the medication. But if the side effect is concerning or bothers you, consider speaking with a healthcare or mental health professional.

Extrapyramidal symptoms

Medications such as Abilify affect your dopamine levels, which may lead to extrapyramidal symptoms. Everyone experiences these symptoms differently, but they typically include three types:

  • Dystonia: muscle contractions, tremors, abnormal posture
  • Akathisia: restlessness and an inability to keep still
  • Parkinsonism: tremors, resistant or slow movement in arms and legs

Safety warning

In 2016, the Food and Drug Administration (FDA) issued a safety warning about taking Abilify. The warning cautions users that some compulsive or uncontrollable urges may occur such as:

They seem to subside once you stop taking the medication. Speaking with a healthcare or mental health professional can help avoid unwanted effects.

Keeping track of any side effects you experience and discussing this with your doctor is recommended. Call 911 or a local emergency room if they become life threatening or are considered a medical emergency, .

Ongoing treatment with Abilify may lead to long-term complications.

Tardive dyskinesia (TD)

Tardive dyskinesia (TD) is a condition seen with ongoing antipsychotic drug therapy. Although the likelihood with Abilify is low, according to a 2019 review, it’s still a concern.

With TD, you may experience involuntary movements of the:

  • tongue
  • neck
  • face
  • limbs
  • trunk
  • jaw

It may happen as early as a month after starting Abilify. Although TD may affect everyone, those who are postmenopausal are the most vulnerable.

In the event of TD, your doctor may discuss other options to replace Abilify.

Metabolic syndrome

Metabolic syndrome is a condition that occurs when taking specific medications such as Abilify. This might lead to:

Your blood sugar and cholesterol levels will be monitored while taking Abilify. Your hemoglobin A1C will also likely be closely monitored to track your blood sugar control over time.

While taking Abilify, eating a balanced diet while remaining active can help prevent conditions such as heart disease and diabetes that may result from metabolic syndrome.

Antidepressants such as SSRIs are most commonly used to treat OCD. Some common SSRIs used include:

SSRIs are effective in treating other mental health conditions such as:

When used for OCD treatment, a higher dose may be prescribed.

Along with Abilify, other medications are often prescribed with SSRIs to help improve outcomes. For example, if you’re experiencing nausea, ondansetron (Zofran) may be recommended to help manage it.

First-line treatment for OCD typically includes therapy such as exposure and response prevention (ERP) and cognitive behavioral therapy (CBT).

Medications such as antidepressants are often used in conjunction with therapy to help manage symptoms. When these treatments aren’t helping, an adjunct medication such as Abilify may be added to your treatment plan.

A healthcare or mental health professional will likely closely monitor you for any side effects.

Try to be as honest with your doctor as possible about what you’re experiencing. One of the best ways to ensure that your medication is helping is by sharing any questions and concerns with your doctor. This open dialogue allows you to play a part in deciding the best course of treatment for you.

If you’d like to learn more about OCD and its treatment, you can check out Psych Central’s OCD Resource Hub to find FAQs and other great resources.

A mental health professional might help you cope and manage intrusive thoughts and behaviors. If you’re interested in learning more, you can check out Psych Central’s guide to finding mental health support.