Published online by Cambridge University Press: 19 October 2021
Aripiprazole has been available since 2002, with long-acting injectable versions approved in 2013 and 2015. Aside from clozapine, all antipsychotics approved prior to aripiprazole acted principally via postsynaptic dopamine D2 receptor antagonism in the associative striatum [2, 3]. While D2 antagonist antipsychotics are very useful, excessively high levels of striatal D2 occupancy (i.e. >> 80% reduction in the postsynaptic dopamine signal) resulted in higher rates of adverse neurological effects (e.g. parkinsonism, akathisia), subjective complaints of dysphoria or decreased well-being, and occasionally symptomatic worsening [4, 5].