As aripiprazole is a partial D2 agonist, one may hypothesize that it may be an effective agent for the management of psychostimulant-addicted patients. The literature published to date is inconclusive. I am using this in my practice.
I used too, with contrasting results. Maybe better in cocaine users, less effective in other psychostimulant users. But it's only my personal clinical experience. In some of such patients I've noted the sudden developing of akathisia after few days of therapy.
I used to prescribe Aripiprazole for Methamphetamine dependency; but most of patients mentioned that Aripiprazole could aggravate their agitation.
It is better to prescribe Olanzapine instead of Aripiprazole! Olanzapine could reduce withdrawal side effects of stimulants such as agitation.
Thank you for you insight Schwann, I have found patients complain of agitation with aripiprazole. Will try olanzapine.
For substance dependence, including to psychostimulants, one should consider medications which reduce the psycho-behavioral and/or somatic dependency on the drug on pharmacodynamical level, mainly in relation to the present developed increase of the sensetization of dopaminergic and noradrenergic receptors (via increased AMPA receptors number, connected to sodium-NA2+ channels), thus here are some suggestions: lamogrigine (sodium-channel blocker, glutamate release blocker; flupethixol (D1/D2 antagonist, 5HT2A), perhaps also zuclopenthixol (D1/D2, alpha-1, H1, 5HT2A antagonist); baclofen (GABA-B agonist); valproate (indirect GABA increase, 5HT1A agonistic properties); perhaps also GABA-ergic drugs such as gabapentin, pregabalin, levetiracetam, oxcarbazepine and topiramate; and, naturally, benzodiazepines, eg diazepam; magnesium and zinc.
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