My First Two Weeks on Aripiprazole (Abilify/Poziat) for OCD

Before starting aripiprazole (Abilify/Poziat), I was taking Rapidal for about a month as an augmentation medication alongside Prozac. I currently take Prozac at 80 mg, which is within the therapeutic range often used for OCD.

I decided to switch because Rapidal was causing side effects that I did not want to continue dealing with. The biggest issues for me were sexual side effects and increased appetite. Even when I was not physically hungry, I found myself thinking about food more often than usual. After discussing this with my psychiatrist, we decided to try aripiprazole at a starting dose of 5 mg.

If you are unfamiliar with aripiprazole, it works differently than many other antipsychotic medications. It is often described as a dopamine stabilizer or partial dopamine agonist. While the exact way it helps OCD is not fully understood, it is commonly used as an augmentation medication when an SSRI alone is not providing enough benefit.

So far, I do think it has helped.

After roughly two weeks, I would estimate that my compulsions and urges to perform compulsions have decreased by around 20% to 30%. That may not sound like much to someone without OCD, but for me it is significant. Any reduction in compulsions can have a meaningful impact on daily life.

The previous medication also helped reduce compulsions, but I personally find aripiprazole easier to tolerate. My libido and sexual function returned relatively quickly after making the switch, which was one of my main concerns. While I still notice a slight increase in appetite, it is nowhere near as strong as what I experienced on Rapidal.

There is no official “therapeutic OCD dose” for aripiprazole in the same way there is for SSRIs. However, augmentation studies commonly use doses between 5 mg and 15 mg, with many people ultimately taking around 10 mg. I am currently on 5 mg and, assuming I continue tolerating it well, my doctor plans to increase me to 10 mg in the near future.

One thing I have noticed is that compulsions seem less rewarding than before. That is difficult to explain, but it feels like there is less of a payoff after completing a ritual. Whether that is related to dopamine modulation or some other mechanism, I cannot say for certain, but it is one of the reasons I feel better on the combination of Prozac and aripiprazole than I did on Prozac alone.

Because I am only two weeks into treatment, I do not think it is fair to draw major conclusions yet. Like many psychiatric medications, the full benefits often take time to develop. Some of the initial side effects I experienced, particularly feeling overly energized and having difficulty sleeping, have already begun improving. My sleep is slowly returning to normal, and the medication feels more manageable than it did during the first week.

Overall, I think the medication is worth discussing with a psychiatrist if you have OCD that is not responding adequately to an SSRI alone. That does not mean it will work for everyone, but so far my experience has been positive.

I plan to provide another update after I have spent more time on the medication and have a better understanding of its long-term benefits and side effects.

Disclaimer: This article reflects my personal experience and is not medical advice. Always consult a qualified healthcare professional before starting, stopping, or changing any medication.