January 11, 2007

Abilify Monitoring Recommended

Doctors Oosterhuis, Kraats and Tenback, writing up a case report in The American Journal of Psychiatry about a single patient with an overly elevated blood level of Abilify (aripiprazole), voiced concerns about its safety in people termed "slow metabolizers". Aripiprazole's metabolism is influenced by CYP2D6 and CYP3A4 genes. These genes control production of specific enzymes important in the metabolism of drugs.

In this case, the patient's high aripiprazole blood level was caused by a common genetic variation (called a polymorphism) in the CYP2D6 gene. The CYP2D6 gene variation slows down the metabolism of aripiprazole. Because the drug is not eliminated as quickly in people with this genetic modification, dangerous levels can accumulate in the person's bloodstream on dosages considered safe in people without that genetic modification.

The doctors say that because poor metabolizing occurs regularly, they recommend monitoring the plasma (blood) concentration after a steady state is achieved (approximately 14 days of treatment).

The doctors also suggest that further aripiprazole safety studies in poor metabolizers are needed.

Read the Case Study: Safety of Aripiprazole: High Serum Levels in a CYP2D6 Mutated Patient
Source: American Journal of Psychiatry

Read more about the CYP2D6 gene modification:
CYP2D6 Gene May Contribute to Persistent Negative Symptoms
Gene Test to Determine Med Doses
Gene identified that could Help Schizophrenia Treatment


Does Abilify affect adults with Douwn Syndrome the same way ? My daughter has DS and is on Abilify 6 mg a day.

Posted by: Marie Misener638 at January 22, 2007 05:11 PM

Your daughter should be able to be monitored just like anybody else. However, if your daughter has already been on Abilify long-term without problems, it means she likely is on the "right" amount for her.

This article more addresses the need to monitor when starting out on the drug (or better yet - run a genetic test before) in order to not overdose the slow metabolizers.


Posted by: Jeanie at January 22, 2007 06:51 PM

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