Drug General Information (ID: DDII3WDPR9)
Drug Name			Aripiprazole		Drug Info		Esketamine		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antipsychotic Agents				Antidepressants
Structure

Mechanism of Aripiprazole-Esketamine Interaction (Severity Level: Moderate)
Additive CNS depression effects Click to Show/Hide Mechanism Graph
Drug Name		Aripiprazole				Esketamine
Mechanism		CNS depression effects				CNS depression effects
Key Mechanism Factor 1
		Factor Name		CNS depression effects
		Factor Description		CNS depressants are drugs that inhibit or suppress brain activity and can reduce mental and physical processes. Excessive CNS depression can lead to decreased heart rate, slow breathing (less than 10 breaths per minute), extreme confusion or loss of memory, nausea and vomiting, poor judgment, blue lips or fingertips, irritability and aggression, and clammy or cold skin.
Mechanism Description		Additive CNS depression effects by the combination of Aripiprazole and Esketamine

Recommended Action
Management		Caution is advised and patients should be closely monitored during concomitant use of esketamine with CNS depressants. Due to the risk of delayed or prolonged sedation and other adverse effects, patients should be monitored for at least 2 hours after esketamine administration, followed by an assessment to determine when the patient is considered clinically stable and ready to leave the healthcare setting. Patients should be instructed not to engage in potentially hazardous activities, such as driving a motor vehicle or operating machinery, until the next day after a restful sleep.

References
1	Cerner Multum, Inc. "Australian Product Information.".
2	Product Information. Spravato (esketamine). Janssen Pharmaceuticals, Titusville, NJ.