A placebo-controlled,double-blind study of the efficacy and safety of aripiprazole for the treatment of acute manic or mixed episodes in Asian patients with bipolar I disorder (the AMAZE study)

Objectives. To investigate the efficacy and safety of aripiprazole in Asian patients with manic or mixed episodes associated with bipolar I disorder. Methods. Subjects were randomised to aripiprazole (24 mg/day; reduced to 12 mg/day if needed for tolerability; n = 128) or placebo (n = 130) for 3 weeks in this multicentre, double-blind study. The primary efficacy measure was mean change from baseline in Young Mania Rating Scale (YMRS) Total score. Results. A total of 136 patients (aripiprazole 56.3%; placebo 49.2%) completed the study. The majority of patients (92.6%) received aripiprazole 24 mg/day. Aripiprazole produced statistically significant mean improvements in YMRS Total scores compared with placebo from Day 4 through to Week 3 (–11.3 vs. –5.3; P < 0.001). The most common adverse events (>?15% of patients; aripiprazole vs. placebo) were akathisia (22.0 vs. 5.6%) and insomnia (16.3 vs. 9.6%). Aripiprazole treatment resulted in no significant difference from placebo in change in mean body weight from baseline (–0.4 vs. –0.7 kg; P = 0.231). Aripiprazole was not associated with an elevated serum prolactin level. Conclusions. Aripiprazole had significantly greater efficacy than placebo for the treatment of acute manic or mixed episodes associated with bipolar I disorder in Asian patients. Treatment was generally safe and well tolerated.     

Utility of aripiprazole in co-occurring problem gambling and toluene dependence: A case report

Inhalant use is a global problem but in spite of its large prevalence and significant physical and psychological complications, there is inadequate literature on the management of inhalant dependence. Inhalants are also considered a substance of adolescence with most users giving up use in adulthood. There is also limited literature on co-occurring behavioral and substance addictions and the linkage between them. We describe the case of 28-year-old man who had been using toluene in a dependent pattern for 14 years. He also had problem gambling in the past, abstaining from which led to an increase in the daily quantity of use of toluene. The patient was tried on Carbabmazepine but following an adverse event he was prescribed Aripiprazole. He improved over the course of 6 weeks and has been abstaining from inhalants since 3 months.     

Review of antipsychotics in children and adolescents

The use of antipsychotics in children and adolescents in the clinical setting is increasing. This article reviews 77 clinical trials published in the last 10 years, investigating their efficacy, effectiveness, safety and pharmacokinetic data in paediatric populations. The diagnostic categories in which the antipsychotics are commonly used (schizophrenia, pervasive developmental disorders, Tourette’s disorder, mental retardation/subaverage intelligence, mood disorders and disruptive behaviour disorders) were used in order to review the evidence and effectiveness. All randomised, double-blind, placebo-controlled trials from the past decade are also summarised. This review refers to recent relevant practice parameters, guidelines and reviews throughout the text. Consistent with previous reviews, it is concluded that the recent trend of increased use of antipsychotics in children and adolescents is not adequately supported by evidence. Specific suggestions have been provided on how to incorporate the existing evidence base into clinical decision making. The review ends with the authors’ opinion on the clinical and research implications for the field and future directions.     

Role of aripiprazole in the management of behavioural and psychological symptoms of dementia: a narrative review

Behavioural and psychological symptoms of dementia affect in a great way quality of life of both patients and their caregivers, which increases the risk of patient institutionalisation when such symptoms are poorly controlled. One of the drugs that are used for controlling behavioural and psychological symptoms of dementia (BPSD) is aripiprazole. This narrative review aims to solve three basic questions. Is aripiprazole useful for the management of these symptoms? Does aripiprazole play a substantial role regarding safety and efficacy, compared with the other pharmacological options available for the same purpose? Has aripiprazole gained importance in treatment regimens of these symptoms, in current clinical practice? We conclude that aripiprazole is effective to manage BPSD. Moreover, it has shown a good safety profile compared with other antipsychotics in advanced disease and frail patients. Thus, aripiprazole has gained importance in current management algorithms for dementia patients mainly due to its efficacy regarding rapid control of agitation and aggressiveness.     

奥氮平与阿立哌唑对精神分裂症患者体质量、血浆神经肽Y及瘦素影响的比较

目的:比较奥氮平和阿立哌唑对精神分裂症患者体质量、血浆神经肽Y及瘦素水平的影响。方法:60例精神分裂症患者随机分为奥氮平组和阿立哌唑组各30例分别治疗8周。在治疗前、治疗后4周和8周测定两组体质量、血浆神经肽Y和瘦素水平并进行治疗前后比较。结果:奥氮平组在治疗4周和8周时体质量(F=287.207,F=506.777)、血浆神经肽Y水平(F=725.697,F=5152.624)明显高于治疗前(P均=0.000);瘦素水平治疗4周时与治疗前差异无统计学意义(F=3.908,P=0.058),治疗8周时高于治疗前(F=1589.726,P=0.000)。阿立哌唑组治疗4周和8周时体质量(F=2.810,F=1.819)、血浆神经肽Y(F=0.232,F=0.376)及瘦素水平(F=0.975,F=1.295)与治疗前比较差异无统计学意义(均P0.05)。奥氮平组治疗4周和8周时体质量的变化与神经肽Y的变化明显正相关(r=0.632,r=0.576;均P0.001),与瘦素的变化无相关(r=0.254,r=0.085;P均0.05)。逐步回归分析显示,奥氮平组神经肽Y变化进入以体质量变化为因变量的回归方程,治疗4周和8周时,神经肽Y变化可以解释体质量变化变异的40.0%和33.1%。结论:与阿立哌唑相比,奥氮平能显著增加精神分裂症患者体质量;血浆神经肽Y水平的变化可能是体质量增加的原因之一。     

阿立哌唑治疗奥氮平所致精神分裂症患者体质量增加的随机双盲对照研究

目的:探讨阿立哌唑干预奥氮平所致体质量增加的有效性及安全性。方法:将服用单一奥氮平治疗所致体质量增加≥7%的入组对象72例随机分为A组(加服阿立哌唑10 mg组,36例)及B安慰剂组(36例),入组时、治疗4周及8周分别测定体质量、体质量指数(BMI)、空腹血糖(FG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)及高密度脂蛋白(HDL),并用阳性和阴性症状量表(PANSS)评定精神症状。结果:两组治疗前体质量、BMI、FG、TC、TG、LDL、HDL,差异无统计学意义(P0.05)。与治疗前比较,治疗8周,A组体质量、BMI、FG均明显下降(P0.05或P0.01),而HDL有明显增高(P0.05);B组体质量、BMI、FG均明显增高(P0.05或P0.01)。治疗4周体质量、BMI的变化值、治疗第8周体质量、BMI、FG、HDL的变化值,两组均差异有统计学意义(P0.05或P0.01)。结论:阿立哌唑能有效减轻奥氮平所致体质量增加和糖脂代谢紊乱。     

阿立哌唑治疗阿尔茨海默病伴发精神行为症状对照研究

目的：探讨阿立哌唑治疗阿尔茨海默病伴发精神行为症状的疗效及安全性。方法将60例阿尔茨海默病伴发精神行为症状患者随机分为两组,研究组口服阿立哌唑治疗,对照组口服奋乃静治疗,观察6周。于治疗前后采用阳性与阴性症状量表评定疗效,副反应量表评定不良反应。结果治疗2周末起两组阳性与阴性症状量表总分及各因子分均较治疗前显著下降（ P＜0．05或0．01）,治疗6周末研究组有效率93．3％,对照组为90．0％,两组有效率比较差异无显著性（χ2＝0．22,P＞0．05）。研究组锥体外系反应（静坐不能、震颤、肌肉强直）发生率显著低于对照组（P＜0．01）。结论阿立哌唑治疗阿尔茨海默病伴发精神行为症状疗效显著,与奋乃静相当,但阿立哌唑治疗安全性更高,有利于提高患者的治疗依从性和生活质量。     

阿立哌唑口崩片与利培酮治疗精神分裂症对照研究

目的：探讨阿立哌唑口崩片与利培酮治疗精神分裂症患者的临床疗效和安全性。方法将60例精神分裂症患者随机分为两组,每组30例,研究组口服阿立哌唑口崩片治疗,对照组口服利培酮片治疗,观察12周。治疗前后采用阳性与阴性症状量表评定临床疗效,副反应量表评定不良反应。结果治疗后两组阳性与阴性症状量表总分及各因子分均较治疗前显著下降（P＜0.01）,治疗各时点两组评分比较差异均无显著性（P＞0.05）,治疗12周末研究组有效率86.7％,对照组为83.3％,两组比较差异无显著性（ P＞0.05）。两组不良反应均轻微,研究组治疗第12周末副反应量表评分显著低于对照组（ P＜0.05）。结论阿立哌唑口崩片与利培酮治疗精神分裂症疗效显著且相当,但阿立哌唑口崩片安全性更高,依从性更好。