Adjunctive Aripiprazole in Treatment-Resistant Bipolar Depression

Ketter, Terence A.; Wang, Po; Chandler, Rebecca A.; Culver, Jenifer L.; Alarcón, Andrea

doi:10.1080/10401230600801176

Cited by 51 publications

(24 citation statements)

References 30 publications

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“…Since preliminary studies with aripiprazole showed benefit in the treatment of bipolar depression, future studies evaluating aripiprazole, using more conservative dosing regimens, are needed to further elucidate its role for this indication. [35][36][37] The primary limitation of our study was its retrospective design, which permitted only data previously recorded in patient charts to be included in the analysis. Thus, limited information on the rationale for product selection, reason(s) for treatment discontinuation, and duration and severity of illness was available.…”

Section: Discussionmentioning

confidence: 99%

An Evaluation of Inpatient Treatment Continuation and Hospital Readmission Rates in Patients with Bipolar Disorder Treated with Aripiprazole or Quetiapine

Kreys

Fabian

Saul

et al. 2013

Journal of Psychiatric Practice

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Section: Discussionmentioning

confidence: 99%

An Evaluation of Inpatient Treatment Continuation and Hospital Readmission Rates in Patients with Bipolar Disorder Treated with Aripiprazole or Quetiapine

Kreys

Fabian

Saul

et al. 2013

Journal of Psychiatric Practice

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“…16,[21][22][23][24][25][26][27][28][29] Furthermore, aripiprazole also demonstrated a low potential for weight gain when used as adjunctive treatment in patients with bipolar mania 29 or bipolar depression. 30 It is possible that concomitant prescription of aripiprazole with antidepressants may increase risk of weight gain. It is important to note that, even in this population already at risk for metabolic disturbance (more than 50% of patients had a baseline body mass index > 30 kg/m 2 ), change in weight did not translate into a worsening of metabolic parameters, such as lipid or glucose levels.…”

Section: Discussionmentioning

confidence: 99%

Safety and Tolerability of Adjunctive Aripiprazole in Major Depressive Disorder

Nelson¹,

Thase²,

Trivedi³

et al. 2009

Prim. Care Companion J. Clin. Psychiatry

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Objective: To evaluate the safety and tolerability of aripiprazole adjunctive to standard antidepressant therapy (ADT) for patients with major depressive disorder (DSM-IV-TR criteria).Method: Data from 2 identical studies of aripiprazole augmentation (8 weeks of prospective ADT treatment followed by 6 weeks of randomized double-blind adjunctive treatment) were pooled. The incidence of treatmentemergent adverse events (TEAEs) and weight, electrocardiogram (ECG), and laboratory measurements were assessed during the 6-week phase, including time course, severity, resolution, and predictors. The studies were Results: The safety analysis included 737 outpatients (aripiprazole, n = 371; placebo, n = 366). The majority of patients completed the trials (aripiprazole, 86%; placebo, 88%). Common TEAEs (≥ 5% and twice the placebo rate) with aripiprazole were akathisia (25%), restlessness (12%), insomnia (8%), fatigue (8%), blurred vision (6%), and constipation (5%). Most TEAEs were of mild to moderate severity (aripiprazole, 89%; placebo, 95%). TEAE rates in the aripiprazole and placebo groups were not affected by ADT, age, or gender. Discontinuation due to TEAEs was low (aripiprazole, 3%; placebo, 1%). Mean weight change was higher with aripiprazole versus placebo (1.73 kg vs 0.38 kg, P < .001). At endpoint, clinical laboratory parameters, vital signs, and ECG indices (including QT c interval) were similar between groups. Akathisia with aripiprazole generally occurred in the first 3 weeks (76%), was of mild to moderate severity (92%), and led to discontinuation in 3 patients (0.8%). Within the aripiprazole group, age (18-40 years) was the only positive predictor for akathisia.Conclusions: In this short-term post hoc analysis, aripiprazole as augmentation to ADT demonstrated a safety and tolerability profile similar to that in monotherapy studies in other psychiatric populations. Controlled long-term safety and efficacy data of aripiprazole as adjunctive to ADT are warranted.

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“…There have been six open-label case studies of aripiprazole augmentation in bipolar depression (Ketter et al 2006; Kemp et al 2007; McElroy et al 2007; Dunn et al 2008; Sokolski 2007; Mazza et al 2008). Three of the studies were retrospective chart reviews of patients with treatment-resistant depression (Ketter et al 2006; Kemp et al 2007; Sokolski 2007), and all but one study included both bipolar I and II patients (Sokolski 2007).…”

Section: Discussionmentioning

confidence: 99%

Aripiprazole as augmentation therapy in bipolar patients with current minor or subsyndromal mood symptoms

Schweitzer

Sarris

Tuckwell

et al. 2013

Int J Bipolar Disord

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Background This study aims to evaluate the effectiveness of aripiprazole augmentation of maintenance treatment for bipolar disorder in patients with minor or subsyndromal mood episodes while on a stable dose of a mood stabiliser and/or antidepressant. Methods All subjects had a diagnosis of bipolar I or II disorder (Diagnostic and Statistical Manual of Mental Disorders-4th Edition, Text Revision). Open-label aripiprazole was given over 8 weeks initially. The starting dose was 5 to 15 mg/day with a mean final dose of 11.5 mg (±4.6). Patients were assessed at weeks 0, 2, 4 and 8 with the Montgomery-Asberg Depression Rating Scale (MADRS), Young Mania Rating Scale (YMRS) and Clinical Global Impression of Severity (CGI-S). Results and discussion Seventeen of 20 (85%) patients completed week 4, while 14 (70%) patients completed 8 weeks. For intention-to-treat data, there was a significant decrease in MADRS scores over the course of treatment, with a reduction of 6.40 points at endpoint ( p < 0.0005). Improvement from baseline was significant at week 2 and remained through to week 8. Similarly, CGI-S scores significantly decreased over the course of study, but not YMRS scores. Aripiprazole was shown to be a modestly effective augmentation therapy for depressive symptoms in bipolar I and II in this small open-label study.

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Adjunctive Aripiprazole in Treatment-Resistant Bipolar Depression

Abstract: Aripiprazole appeared effective and generally well tolerated in treatment-resistant bipolar depression. Controlled trials are warranted to systematically explore these preliminary naturalistic observations.

Cited by 51 publications

References 30 publications

An Evaluation of Inpatient Treatment Continuation and Hospital Readmission Rates in Patients with Bipolar Disorder Treated with Aripiprazole or Quetiapine

An Evaluation of Inpatient Treatment Continuation and Hospital Readmission Rates in Patients with Bipolar Disorder Treated with Aripiprazole or Quetiapine

Safety and Tolerability of Adjunctive Aripiprazole in Major Depressive Disorder

Aripiprazole as augmentation therapy in bipolar patients with current minor or subsyndromal mood symptoms

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