Adding aripiprazole to carbamazepine.
- Carbamazepine is principally metabolized by CYP3A4, and is a potent inducer of CYP1A2, CYP2C9, CYP3A4 and UDP-glucuronosyltransferases.
- Aripiprazole is metabolized by CYP2D6 and CYP3A4 to an active metabolite.
- This combination of drugs may have possible synergistic effects. However, the pharmacokinetic drug interactions will influence the plasma levels. Dose adaptation will be recommended for this combination.
- Coadministration with carbamazepine may decrease the plasma concentrations of aripiprazole via induction of CYP450 3A4 and p-glycoprotein.
- Aripiprazole should be given at higher dosage to control psychotic symptoms. 
- Pharmacologic response and plasma aripiprazole levels should be monitored more closely whenever carbamazepine is added to or withdrawn from therapy.  
- WHO Collaborating Centre for Drug Statistics Methodology ATC=N03AF01
- Farmacotherapeutisch Kompas; Toxicologie (dutch)
- Farmacotherapeutisch Kompas - carbamazepine (dutch)
- KNMP; Informatorium Medicamentorum 2015; Monografie "carbamazepine" (Dutch)
- Interactions between aripiprazole and carbamazepine on drugs.com
- Strack DK et al. Antipsychotic prescribing practices following withdrawal of concomitant carbamazepine. J Psychiatr Pract. 2009 Nov;15(6):442-8
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