Aripiprazole for the treatment of bipolar disorder


Ulusahin A.

KLINIK PSIKOFARMAKOLOJI BULTENI-BULLETIN OF CLINICAL PSYCHOPHARMACOLOGY, vol.18, 2008 (Peer-Reviewed Journal) identifier identifier

  • Publication Type: Article / Article
  • Volume: 18
  • Publication Date: 2008
  • Journal Name: KLINIK PSIKOFARMAKOLOJI BULTENI-BULLETIN OF CLINICAL PSYCHOPHARMACOLOGY
  • Journal Indexes: Science Citation Index Expanded, Scopus, TR DİZİN (ULAKBİM)

Abstract

Second generation antipsychotics are widely used in bipolar disorders both for the treatment of acute mood episodes and for maintenance treatment. Aripiprazole has been proposed as a "third generation antipsychotic". Its unique pharmacological properties are different from other second generation antipsychotic agents. Its efficacy in the treatment of schizophrenia has been established. Efficacy of aripiprazole in manic or mixed episodes and maintenance treatment of bipolar disorder have been studied in several double-blind, randomized, controlled clinical trials in recent years. Few open-label studies of aripiprazole in the treatment of bipolar depression have been published. In the present paper clinical trials assessing the efficacy of aripiprazole in the treatment of acute mood episodes and maintenance treatment of bipolar disorder are examined and advantages and disadvantages of aripiprazole are reviewed. Clinical trials of aripiprazole for acute mania or mixed episodes reveal that it is effective in remitting manic symptoms and does not trigger a depressive episode. One double-blind, randomized, placebo controlled clinical trial of 100-week aripiprazole monotherapy which is the longest clinical trial among the trials conducted in bipolar disorder with second generation antipsychotics showed that aripiprazole was effective for relapse prevention in bipolar patients. Aripiprazole for bipolar depression needs double-blind, randomized, controlled clinical trials. It is well known that some second generation antipsychotics are associated with metabolic disturbances. Aripiprazole's effect on metabolic parameters is more favorable compared with other second generation antipsychotics. Akathisia and tremor are the most common extrapyramical side effects of aripiprazole. Patients with bipolar disorder are more vulnerable to aripiprazole induced akathisia than patients with schizophrenia. In conclusion, aripiprazole is effective for acute mania or mixed episode and maintenance treatment in bipolar disorder, Its different side effect profile from other second generation antipsychotics provides an advantageous position in the treatment of bipolar disorder.