Clozapine-Partial agonist
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Switch medication from Clozapine to Aripiprazole.[1] [2]
Stop Clozapine - Week 1: approx. 75% of initial dose
- Week 2: approx. 50% of initial dose
- Week 3: approx. 25% of initial dose
- Week 4: approx. 12,5% of initial dose
- Day 28: stop
Start Aripiprazole- Day 1-3: start 50% of target dose
- Day 4-7: target dose
More information- Clozapine is generally considered to be more effective than other antipsychotic drugs. Clozapine is often used in treatment-resistant schizophrenia (poor treatment response to 2 or more antipsychotic drugs). So a switch from clozapine to another antipsychotic drug could cause problems regarding effectiveness.[3] [4] [5]
- During this switch you could monitor ECG, especially in patients prone to QT-conduction problems.
- There is a possibility of QT interval prolongation.[6]
— Clozapine — Aripiprazole
- ↑ Switches are based on literature references on this page and expert opinions of the authors. The authors have used pharmacokinetic and receptor affinity properties to determine the switch schedules
- ↑ Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.
- ↑ McEvoy J P et al., Effectiveness of clozapine versus olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia who did not respond to prior atypical antipsychotic treatment. Am J Psychiatry. 2006;163:600–610.
- ↑ Lewis S W et al., Randomized Controlled Trial of Effect of Prescription of Clozapine Versus Other Second-Generation Antipsychotic Drugs in Resistant Schizophrenia. Schizophrenia Bulletin vol.32 no.4 pp.715–723,2006.
- ↑ Agid O, Kapur S, Remington G, Emerging drugs for schizophrenia. Expert Opin Emerg Drugs. 2008 Sep;13(3):479-95.
- ↑ Stöllberger C, Huber JO, Finsterer J, Antipsychotic drugs and QT prolongation. Int Clin Psychopharmacol. 2005 Sep;20(5):243-51.
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