Aripiprazole: what benefits in therapy? Review article
Article Sidebar
Main Article Content
Abstract
Aripiprazole offers a unique combination of receptor actions, including in particular a partial agonist effect on dopamine and serotonin receptors. In terms of the remaining groups of receptors, the interactions are practically negligible. As a result, the drug allows for effective and safe treatments for psychotic and affective disorders. Long-term therapies with aripiprazole outstrip the effectiveness and safety of most of the antipsychotic drugs available today. Aripiprazole has also a positive effect on the improvement of cognitive and social functions.
A practical conclusion from post-authorization clinical trials is that the highest possible doses of aripiprazole (30 mg per day) should be used in the acute period of clinical disorders. The drug is very well tolerated in comparison with standard therapies with other neuroleptics and it has not typical side effects: it does not cause sedation, cardiological hazards, or the risk of accidental or intentional poisoning. Aripiprazole sets the standards for the safety of psychopharmacotherapy today. It reduces the metabolic risk, hyperprolactinemia and osteoporosis. It is commonly used to augment other psychiatric drugs (clozapine, antidepressants, normothymic drugs) and to correct their side effects (olanzapine, antidepressants).
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright: © Medical Education sp. z o.o. License allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
References
2. Shapiro DA, Renock S, Arrington E et al. Aripiprazole, A Novel Atypical Antipsychotic Drug with a Unique and Robust Pharmacology. Neuropsychopharmacology. 2003; 28: 1400-11.
3. Di Sciascio G, Riva MA. Aripiprazole: from pharmacological profile to clinical use. Neuropsychiatr Dis Treat. 2015; 11: 2635-47.
4. Leucht S, Crippa A, Siafis S et al. Dose-Response Meta-Analysis of Antipsychotic Drugs for Acute Schizophrenia. Am J Psychiatry. 2019; 177(4): 342-53. https://doi.org/10.1176/appi.ajp.2019.19010034.
5. Cutler AJ, Marcus RN, Hardy SA et al. The Efficacy and Safety of Lower Doses of Aripiprazole for the Treatment of Patients with Acute Exacerbation of Schizophrenia. CNS Spectr. 2006; 11(9): 691-702.
6. Christensen AP, Boegevig S, Christensen MB et al. Overdoses with Aripiprazole: Signs, Symptoms and Outcome in 239 Exposures Reported to the Danish Poison Information Centre. Basic Clin Pharmacol Toxicol. 2018; 122(2): 293-8.
7. Hori H, Yoshimura R, Katsuki A et al. The cognitive profile of aripiprazole differs from that of other atypical antipsychotics in schizophrenia patients. J Psych Res. 2012; 46: 757-61.
8. Rehse M, Bartolovic M, Baum K et al. Influence of Antipsychotic and Anticholinergic Loads on Cognitive Functions in Patients with Schizophrenia. Schizophr Res Treatment. 2016: 8213165. https://doi.org/10.1155/2016/8213165.
9. Chrzanowski WK, Marcus RN, Torbeyns A et al. Effectiveness of long-term aripiprazole therapy in patients with acutely relapsing or chronic, stable schizophrenia: a 52-week, open-label comparison with olanzapine. Psychopharmacology. 2006; 189: 259-66.
10. McIntyre RS, McElroy SL, Eudicone JM et al. A 52-Week, Double-Blind Evaluation of the Metabolic Effects of Aripiprazole and Lithium in Bipolar I Disorder. Prim Care Companion CNS Disord. 2011; 13(6): PCC.11m01182.
11. Khanna P, Suo T, Komossa K et al. Aripiprazole versus other atypical antipsychotics for schizophrenia. Cochrane Database Syst Rev. 2014; 1: CD006569. https://doi.org/10.1002/14651858. CD006569.pub5.
12. Bervoets C, Morrens M, Vansteelandt K et al. Effect of Aripiprazole on Verbal Memory and Fluency in Schizophrenic Patients. Results from the ESCAPE Study. CNS Drugs. 2012; 26: 975-82.
13. Peuskens J, Bervoets C, Kok F et al. A prospective, multicentre, open-label study to evaluate the effectiveness of aripiprazole in the treatment of a broad range of patients with schizophrenia. Eur Psychiatry. 2012; 27: 506-12.
14. Riedel M, Spellmann I, Schennach-Wolff R et al. Effect of Aripiprazole on Cognition in the Treatment of Patients with Schizophrenia. Pharmacopsychiatry. 2010; 43: 50-7.
15. Zhou Z, Zhu H, Chen L. Effect of Aripiprazole on Mismatch Negativity (MMN) in Schizophrenia. PLOS ONE. 2013; 8(1): e52186.
16. Bodnar M, Malla AK, Makowski C et al. The effect of second-generation antipsychotics on hippocampal volume in first episode of psychosis: longitudinal study. BJ Psych Open. 2016; 2: 139-46.
17. Benedetti A, Di Paolo A, Lastella M et al. Augmentation of Clozapine with Aripiprazole in Severe Psychotic Bipolar and Schizoaffective Disorders: A Pilot Study. Clin Pract Epidemiol Ment Health. 2010; 6: 30-5.
18. Ziegenbein M, Wittmann G, Kropp S. Aripiprazole Augmentation of Clozapine in Treatment-Resistant Schizophrenia. A Clinical Observation. Clin Drug Invest. 2006; 26(3): 117-24.
19. Henderson DC, Fan X, Copeland PM et al. Aripiprazole added to Overweight and Obese Olanzapine-treated Schizophrenia Patients. J Clin Psychopharmacol. 2009; 29(2): 165-9.
20. Casey DE, Laubmeier KK, Marler SV et al. Efficacy of Adjunctive Aripiprazole in Major Depressive Disorder: A Pooled Response Quartile Analysis and the Predictive Value of Week 2 Early Response. Prim Care Companion CNS Disord. 2012; 14(3): PCC.11m01251.
21. Fava M, Dording CM, Baker RA et al. Effects of Adjunctive Aripiprazole on Sexual Functioning in Patients With Major Depressive Disorder and an Inadequate Response to Standard Antidepressant Monotherapy: A Post Hoc Analysis of 3 Randomized, Double-Blind, Placebo-Controlled Studies. Prim Care Companion CNS Disord. 2011; 13(1): PCC.10m00994.
22. Han C, Wang SM, Kwak KP et al. Aripiprazole augmentation versus antidepressant switching for patients with major depressive disorder: A 6-week, randomized, rater-blinded, prospective study. J Psych Res. 2015; 66-67: 84-94.
23. De Bartolomeis A, Perugi G. Combination of aripiprazole with mood stabilizers for the treatment of bipolar disorder: from acute mania to long-term maintenance. Expert Opin Pharmacother. 2012; 13(14): 2027-36. https://doi.org/10.1517/14656566. 2012.719876.
24. Brown R, Taylor MJ, Gededs J. Aripiprazole alone or in combination for acute mania (review). Cochrane Library. 2013; 12: CD005000.
25. Wenzel-Seifert K, Wittmann M, Haen E. QTc Prolongation by Psychotropic Drugs and the Risk of Torsade de Pointes. Dtsch Arztebl Int. 2011; 108(41): 687-93.
26. Barak Y, Aizenberg D. Switching to Aripiprazole as a Strategy for Weight Reduction: A Meta-Analysis in Patients Suffering from Schizophrenia. J Obesity. 2011: 898013: https://doi.org/10.1155/2011/898013.
27. Newcomer JW, Meyer JM, Baker RA et al. Changes in Non-high-density Lipoprotein Cholesterol Levels and Triglyceride/ High-density Lipoprotein Cholesterol Ratios among Patients Randomized to Aripiprazole versus Olanzapine. Schizophr Res. 2008; 106(0): 300-7.
28. Kessing LV, Thomsen AF, Mogensen UB et al. Treatment with antipsychotics and the risk of diabetes in clinical practice. Br J Psychiatry. 2010; 197: 266-71.
29. Yood MU, DeLorenze M, Quesenberry Jr CP et al. Epidemiologic study of aripiprazole use and the incidence of suicide events. Pharmacoepidemiol Drug Saf. 2010; 19: 1124-30.
30. Colombo GL, Caruggi M, Di Matteo S et al. An economic evaluation of aripiprazole vs olanzapine adapted to the Italian setting using outcomes of metabolic syndrome and risk for diabetes in patients with schizophrenia. Neuropsychiatr Dis Treat. 2008; 4(5): 967-76.
31. Zhao J, Song X, Ai X et al. Adjunctive Aripiprazole Treatment for Risperidone-Induced Hyperprolactinemia: An 8-Week Randomized, Open-Label, Comparative Clinical Trial. PLOS ONE. 2015; 10(10): e0139717.
32. Gomez L, Stubbs B, Shirazi A et al. Lower Bone Mineral Density at the Hip and Lumbar Spine in People with Psychosis Versus Controls: a Comprehensive Review and Skeletal Site-Specific Meta-analysis. Curr Osteoporos Rep. 2016; 14: 249-59.