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decreasing Aripiprazole - what to look out for?


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As notloki said, the long half-life makes for a smooth auto-taper. I've gone from 30 mg to 0 mg several times without any withdrawal effects at all. The thing to watch out for is a return of symptoms. That's a bitch. It's just a reminder that the disease is still there.

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Aripriprazole is a dopamine D2 partial agonist (30%) on posynaptic receptors and partial agonist (75%) on presynaptic receptors .

At low doses it has an stimulating effect.

At high doses it has a sedative effect.

Aripriprazole is a 5HT1A partial agonist (68%) also; which leads to dopamine release in the prefrontal cortex. Due to partial agonism on D2, D3, D4, Aripriprazole modulates dopamine levels in the mesocortical pathway; by increasing activity where it is absent or low; and reducing activity where it is high. Aripriprazole is also a 5HT2A antagonist as are atypical antipsychotics; this has antipsychotic and anti-manic effects.

Look out for dopamine supersensitivity; 

The long term use of antipsychotics causes extra dopamine receptors to be produced by the brain; this is called upregulation. The brain's dopamine receptors upregulate under the blockade of the antipsychotic agent. Antipsychotics cover 70% - 90% of dopamine receptors. The brain, in an effort to maintain homeostatic equilibrium produces more dopamine receptors on receiving neurons in order to sensitize the neurons to dopamine called "dopamine supersensitivity" which is associated with a risk of relapse. Antipsychotics have withdrawal effects; So taper off the antipsychotic; do not abruptly withdraw the drug.

 

 

Edited by Truthometer
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