Efficacy and Safety of Aripiprazole in the Treatment of Bipolar Disorder: a Systematic Review

Overview

Journal Ann Gen Psychiatry

Publisher Biomed Central

Specialty Psychiatry

Date 2009 Jul 29

PMID 19635147

Citations 11

Authors

Konstantinos N Fountoulakis

Eduard Vieta

Affiliations

Soon will be listed here.

Abstract

Background: The current article is a systematic review concerning the efficacy and safety of aripiprazole in the treatment of bipolar disorder.

Methods: A systematic Medline and repositories search concerning the usefulness of aripiprazole in bipolar disorder was performed, with the combination of the words 'aripiprazole' and 'bipolar'.

Results: The search returned 184 articles and was last updated on 15 April 2009. An additional search included repositories of clinical trials and previous systematic reviews specifically in order to trace unpublished trials. There were seven placebo-controlled randomised controlled trials (RCTs), six with comparator studies and one with add-on studies. They assessed the usefulness of aripiprazole in acute mania, acute bipolar depression and during the maintenance phase in comparison to placebo, lithium or haloperidol.

Conclusion: Aripiprazole appears effective for the treatment and prophylaxis against mania. The data on bipolar depression are so far negative, however there is a need for further study at lower dosages. The most frequent adverse effects are extrapyramidal signs and symptoms, especially akathisia, without any significant weight gain, hyperprolactinaemia or laboratory test changes.

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References

Kalinichev M, Rourke C, Daniels A, Grizzle M, S Britt C, Ignar D . Characterisation of olanzapine-induced weight gain and effect of aripiprazole vs olanzapine on body weight and prolactin secretion in female rats. Psychopharmacology (Berl). 2005; 182(2):220-31. DOI: 10.1007/s00213-005-0081-9. View

Behere R, Venkatasubramanian G, Naveen M, Gangadhar B . Aripiprazole-induced hyponatremia: a case report. J Clin Psychiatry. 2007; 68(4):640-1. DOI: 10.4088/jcp.v68n0423g. View

Goodnick P, Jerry J . Aripiprazole: profile on efficacy and safety. Expert Opin Pharmacother. 2002; 3(12):1773-81. DOI: 10.1517/14656566.3.12.1773. View

Tadori Y, Forbes R, McQuade R, Kikuchi T . Characterization of aripiprazole partial agonist activity at human dopamine D3 receptors. Eur J Pharmacol. 2008; 597(1-3):27-33. DOI: 10.1016/j.ejphar.2008.09.008. View

Vieta E, Tjoen C, McQuade R, Carson Jr W, Marcus R, Sanchez R . Efficacy of adjunctive aripiprazole to either valproate or lithium in bipolar mania patients partially nonresponsive to valproate/lithium monotherapy: a placebo-controlled study. Am J Psychiatry. 2008; 165(10):1316-25. DOI: 10.1176/appi.ajp.2008.07101560. View

Mallikaarjun S, Shoaf S, Boulton D, Bramer S . Effects of hepatic or renal impairment on the pharmacokinetics of aripiprazole. Clin Pharmacokinet. 2008; 47(8):533-42. DOI: 10.2165/00003088-200847080-00003. View

Fountoulakis K . The contemporary face of bipolar illness: complex diagnostic and therapeutic challenges. CNS Spectr. 2008; 13(9):763-74, 777-9. DOI: 10.1017/s1092852900013894. View

Aitchison K, Bienroth M, Cookson J, Gray R, Haddad P, Moore B . A UK consensus on the administration of aripiprazole for the treatment of mania. J Psychopharmacol. 2008; 23(3):231-40. DOI: 10.1177/0269881108098820. View

Lorenz R, Weinstein B . Resolution of haloperidol-induced hyperprolactinemia with aripiprazole. J Clin Psychopharmacol. 2007; 27(5):524-5. DOI: 10.1097/JCP.0b013e31814f4d5d. View

10.

Witschy J, Winter A . Improvement in tardive dyskinesia with aripiprazole use. Can J Psychiatry. 2005; 50(3):188. DOI: 10.1177/070674370505000321. View

11.

Dunn R, Stan V, Chriki L, Filkowski M, Ghaemi S . A prospective, open-label study of Aripiprazole mono- and adjunctive treatment in acute bipolar depression. J Affect Disord. 2008; 110(1-2):70-4. DOI: 10.1016/j.jad.2008.01.004. View

12.

McElroy S, Suppes T, Frye M, Altshuler L, Stanford K, Martens B . Open-label aripiprazole in the treatment of acute bipolar depression: a prospective pilot trial. J Affect Disord. 2007; 101(1-3):275-81. DOI: 10.1016/j.jad.2006.11.025. View

13.

Sachs G, Sanchez R, Marcus R, Stock E, McQuade R, Carson W . Aripiprazole in the treatment of acute manic or mixed episodes in patients with bipolar I disorder: a 3-week placebo-controlled study. J Psychopharmacol. 2006; 20(4):536-46. DOI: 10.1177/0269881106059693. View

14.

Sanford M, Scott L . Intramuscular aripiprazole : a review of its use in the management of agitation in schizophrenia and bipolar I disorder. CNS Drugs. 2008; 22(4):335-52. DOI: 10.2165/00023210-200822040-00005. View

15.

Schou M, BAASTRUP P . Lithium treatment of manic-depressive disorder. Dosage and control. JAMA. 1967; 201(9):696-8. View

16.

Himmelhoch J, Mulla D, NEIL J, DETRE T, Kupfer D . Incidence and signficiance of mixed affective states in a bipolar population. Arch Gen Psychiatry. 1976; 33(9):1062-6. DOI: 10.1001/archpsyc.1976.01770090052004. View

17.

Stark A, Jordan S, Allers K, Bertekap R, Chen R, Mistry Kannan T . Interaction of the novel antipsychotic aripiprazole with 5-HT1A and 5-HT 2A receptors: functional receptor-binding and in vivo electrophysiological studies. Psychopharmacology (Berl). 2007; 190(3):373-82. DOI: 10.1007/s00213-006-0621-y. View

18.

DeLeon A, Patel N, Crismon M . Aripiprazole: a comprehensive review of its pharmacology, clinical efficacy, and tolerability. Clin Ther. 2004; 26(5):649-66. DOI: 10.1016/s0149-2918(04)90066-5. View

19.

BAASTRUP P, Poulsen J, Schou M, Thomsen K, Amdisen A . Prophylactic lithium: double blind discontinuation in manic-depressive and recurrent-depressive disorders. Lancet. 1970; 2(7668):326-30. DOI: 10.1016/s0140-6736(70)92870-9. View

20.

Ketter T, Wang P, Chandler R, Culver J, Alarcon A . Adjunctive aripiprazole in treatment-resistant bipolar depression. Ann Clin Psychiatry. 2006; 18(3):169-72. DOI: 10.1080/10401230600801176. View