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Sir: Aripiprazole is a new atypical antipsychotic with a partial agonist activity at D2 and 5-HT1A receptors and with potent 5-HT2A receptor antagonism. Dose titration is considered necessary by some authors,1 but not by others.2,3 Recently, multiple cases of worsening of psychotic symptoms after add-on treatment with aripiprazole have been reported.4-8