Latest research on Aripiprazole

Aripiprazole is an atypical antipsychotic medication used for the treatment of schizophrenia. It has also recently received FDA approval for the treatment of acute manic and mixed episodes associated with bipolar disorder. Aripiprazole appears to mediate its antipsychotic effects primarily by partial agonism at the D2 receptor. In addition to partial agonist activity at the D2 receptor, aripiprazole is also a partial agonist at the 5-HT1A receptor, and like the other atypical antipsychotics, aripiprazole displays an antagonist profile at the 5-HT2A receptor. Aripiprazole has moderate affinity for histamine and alpha adrenergic receptors, and no appreciable affinity for cholinergic muscarinic receptors.

Latest findings

His medication history included fluoxetine, Sertraline, Paroxetine, Escitalopram, Desvenlafaxine, Duloxetine, Levetiracetam, VALPROIC acid, Oxcarbazepine, ezogabine, Aripiprazole, Quetiapine fumarate, Chlorpromazine, Mesoridazine, and Lithium. [source, 2015]
Concerning medication, three patients were free of any antipsychotic medication, the others received mono- or dual therapy with atypical antipsychotic medication including Amisulpride (n = 2), Olanzapine (n = 11), Clozapine (n = 4), Quetiapine (n = 2), Ziprasidone (n = 1), Risperidone (n = 5), Aripiprazole (n = 2), Paliperidone (n = 3; cp. [source, 2016]
Seventy-five patients were taking atypical antipsychotics (Risperidone, Paliperidone, Clozapine, Aripiprazole, Ziprasidone, and/or Quetiapine) at a median Chlorpromazine equivalent dose of 349.20 (277.64) mg/day. [source, 2016]
We failed to find an association between individual AP drugs and QTc interval, but we observed that people on Aripiprazole were significantly less likely to show QTc prolongation, which persisted after controlling for AP dose and polypharmacy (Table 2). [source, 2016]
The dosages for Olanzapine, Quetiapine and Aripiprazole were 0.5 mg/kg/day22, 15 mg/kg/day23 and 5 mg/kg/day24, respectively. [source, 2015]
Second, Aripiprazole resulted, in comparison with all other AP drugs, associated with a reduced risk of QTc prolongation. [source, 2016]
This finding is consistent with the conclusions of a systematic review that investigated the cardiac safety of Aripiprazole treatment in patients at high risk for torsade [20]. [source, 2016]
In addition, experimental data from placebo and head-to-head comparisons between different AP drugs found that Aripiprazole was not associated with significant QTc prolongation compared with placebo, and that it was the second best choice in terms of risk of ECG abnormalities second only to lurasidone [21]. [source, 2016]
Another limitation relates to the small numbers of patients taking some individual drugs, resulting in both limited statistical power to detect associations with QTc interval and unfeasibility to test associations between QTc prolongation and some “classical” AP combinations (e.g. those involving Aripiprazole or Clozapine) recommended by evidence-based guidelines [24]. [source, 2016]
Data on individual AP drugs are more controversial, with individual phenothiazines and butyrophenones (e.g., Haloperidol) carrying a higher risk as compared with some individual second-generation AP drugs, such as Quetiapine and Olanzapine, which may have a moderate risk, or Aripiprazole, possibly showing a lower potential to cause QTc prolongation [3;4]. [source, 2016]