Major
Probable
Description
Aripiprazole acts as a partial D2 agonist/antagonist and can oppose levodopa's dopaminergic therapy, worsening Parkinson's disease symptoms.
Mechanism
Aripiprazole's partial D2 agonism results in net D2 receptor blockade in the context of high dopamine from levodopa therapy, impairing motor function.
Clinical Significance
Parkinson's patients treated with dopaminergic therapy can experience marked motor deterioration when any D2-acting antipsychotic is initiated.
Management
Avoid aripiprazole in Parkinson's disease; use medications with minimal D2 blockade for psychosis treatment in these patients.