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

There is evidence that Aripiprazole is at least as effective as Haloperidol against the positive and negative symptoms of schizophrenia (Kane et al. 2002; Kasper et al. 2003), more effective in ameliorating the associated mood symptoms (Kasper et al. 2003), and is associated with a lower incidence of adverse events, particularly EPS. [source, 2006]
Aripiprazole also appears as effective as other atypical antipsychotics in the treatment of the positive and negative symptoms of schizophrenia. [source, 2006]
Importantly, Aripiprazole is not associated with an increased risk of weight gain, metabolic disturbances, or increases in prolactin levels. [source, 2006]
Further observational studies, and evidence on cost effectiveness and resource utilization, and on the patient-oriented outcomes of quality of life, general functioning, and satisfaction with treatment would help with defining the place in therapy of Aripiprazole (El-Sayeh & Morganti 2004), especially compared with other atypical antipsychotics. [source, 2006]
Also, although EPS is less common with Aripiprazole, tremor and akathisia have been reported in longer-term studies (Kasper et al. 2003; Pigott et al. 2003; McQuade et al. 2004), suggesting a need for more evidence from long-term clinical use on the potential for development of tardive dyskinesia with Aripiprazole. [source, 2006]
There is no evidence that Aripiprazole is effective in treatment-resistant patients. [source, 2006]
Interestingly, however, despite substantial numbers of patients leaving trials, fewer patients on Aripiprazole discontinued treatment compared with other antipsychotics, either due to insufficient clinical response, worsening of illness, or adverse effects. [source, 2006]
Not only were discontinuation rates lower for Aripiprazole in controlled trials, where treatment-resistant patients were excluded, but also in observational studies. [source, 2006]
A recent large-scale prospective effectiveness study in general psychiatry outpatient practice settings confirmed this finding, with a lower proportion of discontinuations among Aripiprazole recipients than with active controls (Tandon et al. 2006). [source, 2006]
In conclusion, Aripiprazole is an effective atypical antipsychotic and therefore may be considered as a first-line agent. [source, 2006]