Medication Madness: Aripiprazole-Induced Psychosis

Aripiprazole is an atypical antipsychotic that is FDA approved to treat a variety of psychiatric illnesses, including schizophrenia, bipolar I disorder, autism spectrum disorder, Tourette’s disorder, and as an adjunctive therapy in combination with an antidepressant in the treatment of major depressive disorder (MDD).1 Its mechanism of action is as a partial agonist at dopamine (D2) and serotonin (5-HT1A) receptors, as well as an antagonist at 5-HT2A receptors. 2 Due to its partial agonist activity at the dopamine D2 receptor, aripiprazole can lead to gambling problems or other intense urges or behaviors, such as increased sexual urges, excessive shopping, and binge eating. 1In addition, it can also lead to side effects that are commonly associated with antipsychotics which include tardive dyskinesia, neuroleptic malignant syndrome, and metabolic changes such as hyperglycemia, dyslipidemia, and weight gain. 3 Although there is no clear evidence of psychosis as a side effect of aripiprazole use, it is suggested that this is a possibility due to its partial D2 agonist mechanism of action. We are presenting a patient who was treated with aripiprazole as adjunctive therapy to treat MDD, which led to an acute psychotic episode.

This poster was presented at the 32nd annual Psych Congress, held Oct. 3-6, 2019, in San Diego, California.