Suggested therapeutic ranges for aripiprazole (100 to 350 mcg/L) and for aripiprazole plus dehydro-aripiprazole (150 to 500 mcg/L) follow the recommendations of the AGNP (1). Large variations of plasma levels have been seen in adolescent patients with schizophrenia (2).
Aripiprazole is an atypical antipsychotic and mainly used in the treatment of schizophrenia and bipolar disorder. Common side effects include weight gain, movement disorders as well as constipation and sleepiness. Aripiprazole is metabolised by CYP2D6 and CYP3A4. Medications that inhibit the cytochrome enzymes (for example selective serotonin uptake inhibitors) or induce the enzymes (e.g. carbamazepine) will increase or decrease plasma levels of aripiprazole. Dehydroaripiprazole is an active metabolite and in the steady state will be about 40% of the plasma concentration of aripiprazole. Aripiprazole has a long half-life (50 to 70 hours) and will require 14 days before achieving steady-state.
1. Hiemke C, et al. Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology: Update 2017. Pharmacopsychiatry. 2018 Jan;51(1-02):e1. doi: 10.1055/s-0037-1600991. Epub 2018 Feb 1.
2. Bachmann CJ, et al. Large variability of aripiprazole and dehydroaripiprazole serum concentrations in adolescent patients with schizophrenia. Ther Drug Monit 2008; 30: 462–466
Performed by LC-MS/MS