Aripiprazole in schizophrenia and schizoaffective disorder: A review |
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| Authors: | Emmanuel Stip Valérie Tourjman |
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| Affiliation: | 1. Centre de Recherche Fernand Seguin, Hôpital L.-H. Lafontaine, Université de Montréal, Montréal, Québec, Canada;2. Hôpital Sacré-C?ur, Montréal, Québec, Canada;1. Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Huispostnummer A 00.241, Postbus 85500, 3508 GA Utrecht, Utrecht, The Netherlands;2. Pro Persona Mental Health Care, Expertise Center for Psychosis, UMC St Radboud, Huispostnummer 958, Postbus 9101, 6500 HB Nijmegen, Nijmegen, The Netherlands;3. DeltaBouman Psychiatric Teaching Hospital, Poortugaal, Delta Psychiatrisch Centrum, Afdeling Dorpsblik, Postbus 800, 3170 DZ Poortugaal, The Netherlands;4. Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, Faculteit Medische Wetenschappen/UMCG, A Deusinglaan 2, 9718 AW Groningen, The Netherlands;1. Hospital Universitario Virgen del Rocío, Departamento de Psiquiatría, Universidad de Sevilla, IBiS, CIBERSAM, Sevilla, Spain;2. Hospital Universitario Marques de Valdecilla, Departamento de Psiquiatría, Universidad de Cantabria, IDIVAL, CIBERSAM, Santander, Spain;1. Section of Pharmacogenetics, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden;2. Department of Physiology, Faculty of Pharmacy, University of Belgrade, Serbia;3. Center for Psychopharmacology, Diakonhjemmet Hospital, Oslo, Norway;4. Department of Pharmaceutical Biosciences, School of Pharmacy, University of Oslo, Norway;1. Department of Pharmaceutics and Drug Delivery, The University of Mississippi, University 38677, USA;2. BASF SE, R&D Product Management Excipients, Ludwigshafen 67056, Germany;3. BASF Corporation, Tarrytown 10591, USA;4. College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Republic of Korea;5. Pii Center for Pharmaceutical Technology, The University of Mississippi, University 38677, USA;1. Imperial College, London, UK;2. School of Psychiatry, West Midlands Deanery, Birmingham, UK;3. University of Birmingham, UK;4. Birmingham Community Healthcare NHS Trust, UK;5. School of Psychology, University of Birmingham, UK |
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| Abstract: | Background: During the past decade, there has been some progress in the pharmacotherapy of schizophrenia and schizoaffective disorder. Current evidence supports the use of various second-generation, or atypical, antipsychotic medications, although few of these agents have been associated with long-term efficacy and tolerability. Aripiprazole is an atypical antipsychotic that has been found to improve positive and negative symptoms of schizophrenia with a favorable adverse-effect profile.Objective: This article reviews the efficacy and tolerability of aripiprazole in the context of recommended management strategies for schizophrenia and schizoaffective disorder, and in comparison with first-generation and other second-generation antipsychotics.Methods: A search of MEDLINE (1999–May 2009) was conducted for reports of short- and long-term clinical studies of atypical antipsychotics (including aripiprazole) and meta-analyses of randomized controlled trials comparing first- and second-generation antipsychotics (including aripiprazole) in the treatment of schizophrenia or schizoaffective disorder. The search terms were schizophrenia; schizoaffective disorder; pharmacogenetics; adverse effects; tardive dyskinesia AND atypical antipsychotics; aripiprazole; aripiprazole, schizophrenia, AND double-blind studies; and atypical antipsychotics AND adverse effects. The reference lists of identified articles were reviewed for additional relevant publications. Only full study publications were included.Results: Based on the clinical evidence, including data from short-term (4–8 weeks) and long-term (26–52 weeks) randomized, double-blind clinical trials, aripiprazole has been associated with improvements in positive, negative, cognitive, and affective symptoms of schizophrenia and schizoaffective disorder. It has been associated with long-term (up to 52 weeks) symptom control in schizophrenia, as well as with efficacy in treatment-resistant schizophrenia. Common adverse effects associated with aripiprazole were nausea, insomnia, and agitation. These effects were usually transient. The evidence suggests that aripiprazole is unlikely to be associated with clinically significant weight gain or dyslipidemia, increased prolactin levels, or prolongation of the QTc interval. Compared with placebo, aripiprazole has been reported to have a relatively low potential for inducing metabolic syndrome.Conclusions: Based on the evidence reviewed, aripiprazole monotherapy appears to be effective and well tolerated in treating the positive, negative, and cognitive symptoms of schizophrenia and schizoaffective disorder. It was associated with a low risk for the common adverse effects of antipsychotic therapy, including metabolic and endocrine alterations. |
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