A Clozapine and haloperidol serum levels are expected to be halved by phenytoin.
Aripiprazole and sertindole levels are also significantly reduced by phenytoin. The clearance of quetiapine is increased by phenytoin. The serum levels of phenytoin can be raised or lowered by the use of chlorpromazine, prochlorperazine or thioridazine. Fosphenytoin, a prodrug of phenytoin, may interact similarly.
Monitor phenytoin levels if chlorpromazine, prochlorperazine or thioridazine are given. The manufacturers of aripiprazole suggest doubling its dose. Also monitor concurrent use to ensure that the antipsychotics remain effective. It is also important to consider the seizure potential when prescribing antipsychotic medications.
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