Abilify as a second antipsychotic

[MrChance2]

I've inherited a few patients on Abilify + Clozaril or Abilify and another antipsychotic. Thinking about it if Abilify is a partial D2 agonist can it actually weaken the effect on D2 of the other antipsychotic, at least at certain levels? Does anyone know of any good literature on this? I assume the same would be true for Brexpiprazole as well.

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[Sushirolls]

Clinically I've seen some positive results.

 

[clausewitz2]

A metanalysis from last year did not find evidence of increase in positive symptoms associated with addition of or transition to Ability in excess of what is produced by other neuroleptics. There did seem to be a significant increase in discontinuation following transition due to lack of efficacy.

Ability is one of the few really solidly supported augmentation choices for clozaril, seems to improve symptoms as well as reduce weight gain. Remember clozapine is mostly not having its effects by blocking D2.