Aripiprazole for ADHD: mechanism of action and possible uses

A systematic review examined the effect of aripiprazole on ADHD. Only 2 RCTs (randomized controlled trials) were found.¹ No controlled study found an efficacy of aripiprazole on ADHD symptoms. Efficacy of aripiprazole on ADHD was only found in non-controlled studies. There was a very high rate of side effects such as

Weight gain
Sedation
Headaches reported.

One study compared the effects of aripiprazole and risperidone in children with ADHD and comorbid ASD.
Both drugs showed comparable improvement in ADHD symptoms without serious side effects, aripiprazole showed a reduction in prolactin levels.²

One study found a positive effect of a combination therapy of aripiprazole and methylphenidate in children with comorbid DMDD and ADHD. Increased side effects were not found.³

Ghanizadeh (2013): Systematic review of clinical trials of aripiprazole for treating attention deficit hyperactivity disorder. Neurosciences (Riyadh). 2013 Oct;18(4):323-9. PMID: 24141455. ↥
Lamberti, Siracusano, Italiano, Alosi, Cucinotta, Di Rosa, Germanò, Spina, Gagliano (2ß16): Head-to-Head Comparison of Aripiprazole and Risperidone in the Treatment of ADHD Symptoms in Children with Autistic Spectrum Disorder and ADHD: A Pilot, Open-Label, Randomized Controlled Study. Paediatr Drugs. 2016 Aug;18(4):319-29. doi: 10.1007/s40272-016-0183-3. PMID: 27278054. n = 44 ↥
Pan, Fu, Yeh (2018): Aripiprazole/Methylphenidate Combination in Children and Adolescents with Disruptive Mood Dysregulation Disorder and Attention-Deficit/Hyperactivity Disorder: An Open-Label Study. J Child Adolesc Psychopharmacol. 2018 Dec;28(10):682-689. doi: 10.1089/cap.2018.0068. PMID: 30148656. n = 24 ↥