Tolerability of High-Dose Aripiprazole in Treatment-Refractory Schizophrenic Patients

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Sir: Aripiprazole is a new antipsychotic that works as a partial agonist/antagonist at dopamine D₂ and serotonin 5-HT_1A receptors and has a favorable side effect profile.¹ The maximum manufacturer-recommended dose in the United States is 30 mg/day, although patients with a history of antipsychotic nonresponse are likely to be treated with aripiprazole doses over 30 mg. Review of the literature found 1 safety study of 40 patients with stable schizophrenia or schizoaffective disorder who were administered aripiprazole 30 to 90 mg with no dose-dependent increases of adverse events.²‘ ‹