Overdose of aripiprazole, a new type of antipsychotic.
Aripiprazole is the first member of a new class of antipsychotic medications. Unlike other antipsychotics, it acts as a partial agonist at dopamine D(2) and 5-HT(1A) receptors, thereby mitigating most of the adverse reactions such as extrapyramidal side effects and hyperprolactinemia. Additionally, most research to date has suggested a low incidence of QTc prolongation and orthostatic hypotension at therapeutic doses. Experience in the setting of intentional overdose, however, is limited. We present a case of a 27-year-old woman who intentionally ingested 330 mg of aripiprazole in a suicide attempt. Clinical effects were limited to mild sedation. Serum levels performed by the drug's manufacturer confirmed a total level (parent drug and active metabolite) of 716 ng/mL, nearly six times the upper limit of accepted therapeutic levels. This suggests that aripiprazole's therapeutic index is quite high and reinforces the drug's known safety profile.
Carstairs
Shaun D
SD
Department of Emergency Medicine, Naval Medical Center, San Diego, California.
Williams
Saralyn R
SR
Division of Medical Toxicology, Department of Emergency Medicine, University of California, San Diego Medical Center, San Diego, California; California Poison Control System, San Diego Division, San Diego, California.
D000328:Adult; D014150:Antipsychotic Agents / Q000506:poisoning*; D000068180:Aripiprazole; D062787:Drug Overdose; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D010879:Piperazines / Q000506:poisoning*; D015363:Quinolones / Q000506:poisoning*; D013406:Suicide, Attempted
D014150:Antipsychotic Agents; D010879:Piperazines; D015363:Quinolones; D000068180:Aripiprazole