What is known and objective: Long-acting injectable (LAI) antipsychotics are an integral part of mental health treatment. Modifying an LAI regimen poses several challenges because of the extended half-life of the drug.
Case summary: An acutely psychotic patient with schizoaffective disorder received aripiprazole lauroxil without resolution of symptoms. She was started on a previously successful regimen of oral fluphenazine. Due to continued psychosis, oral carbamazepine was initiated to expedite the LAI's metabolism allowing subsequent doses of fluphenazine to impart activity.
What is new and conclusion: Potent cytochrome enzyme inducers may help in transitioning patients from LAI antipsychotics to other therapies.
Keywords: antiepileptic drugs; antipsychotics; aripiprazole; carbamazepine; drug interaction; enzyme induction; metabolism; pharmacodynamics; pharmacokinetics; psychiatry.
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