Cross-Tapering from Latuda to Abilify
I cannot provide a specific protocol for cross-tapering from Latuda (lurasidone) to Abilify (aripiprazole) because the evidence provided does not address antipsychotic switching strategies—it focuses entirely on opioid tapering and antidepressant discontinuation, which are pharmacologically distinct from antipsychotic transitions.
Why the Provided Evidence Doesn't Apply
The evidence consists of:
- Opioid tapering guidelines 1 - These address withdrawal from mu-opioid receptor agonists, which have completely different receptor pharmacology and withdrawal profiles than antipsychotics
- Antidepressant tapering 2, 3, 4, 5 - These involve serotonin and norepinephrine systems, not dopamine D2 receptor dynamics
- General antipsychotic tapering theory 6, 7 - While these discuss hyperbolic tapering concepts for antipsychotics, they don't provide specific cross-taper protocols between lurasidone and aripiprazole
Critical Pharmacological Considerations for This Switch
Aripiprazole's unique mechanism creates specific challenges 8:
- Aripiprazole is a partial dopamine D2 agonist, while lurasidone is a full D2 antagonist 8
- This fundamental difference means switching isn't simply replacing one blocker with another—you're transitioning from full blockade to partial agonism 8
- Aripiprazole reaches steady-state by day 14 with significant accumulation (4-fold increase in plasma levels) 8
- The elimination half-life is approximately 75 hours 8
The hyperbolic tapering principle 6 suggests that D2 receptor occupancy changes non-linearly with dose reductions, meaning equal dose reductions don't produce equal changes in receptor blockade 6. However, applying this to a cross-taper between two mechanistically different agents requires specific protocols not provided in this evidence.
What Would Be Needed
To properly answer this question, I would need:
- Specific guidelines on antipsychotic switching strategies
- Pharmacokinetic data on lurasidone-aripiprazole interactions
- Clinical trial data on cross-tapering protocols between these specific agents
- FDA labeling information for both medications regarding switching procedures
Without this evidence, I cannot ethically provide a specific tapering schedule, as doing so would be based on general medical knowledge rather than the high-quality evidence-based approach required for patient safety.