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16 - Aripiprazole, Aripiprazole Monohydrate, and Aripiprazole Lauroxil

Published online by Cambridge University Press:  19 October 2021

Jonathan M. Meyer
Affiliation:
University of California, San Diego
Stephen M. Stahl
Affiliation:
University of California, Riverside and San Diego
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Summary

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].

Type
Chapter
Information
The Clinical Use of Antipsychotic Plasma Levels
Stahl's Handbooks
, pp. 318 - 336
Publisher: Cambridge University Press
Print publication year: 2021

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