Aripiprazole as an adjuvant treatment for obsessive and compulsive symptoms in manic phase of bipolar disorder: A randomized, double-blind, placebo-controlled clinical trial

Sahraian, Ali; Ehsaei, Zahra; Mowla, Arash

doi:10.1016/j.pnpbp.2018.03.014

Cited by 16 publications

(18 citation statements)

References 38 publications

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“…Aripiprazole dosage during the follow-up period was established and modified according to clinical judgment. Mean final aripiprazole dosage (15.2 mg/day) was in line with doses used both in studies that demonstrated the efficacy of aripiprazole addition in resistant OCD [17][18][19][20] and in the only study investigating the efficacy of aripiprazole augmentation in BD-OCD patients [21].…”

Section: Discussionsupporting

confidence: 55%

“…Indeed, in our sample at the end of the 12-week observation period, 41.8% of subjects met the criteria for treatment response of OC symptoms and 18.2% showed a partial response, with no difference between patients in lithium or valproate monotherapy. The only study that investigated the efficacy of aripiprazole as an adjuvant treatment for OC symptoms in patients with BD was performed in the manic phase and showed a >34% decrease in mean YBOCS score in more than 90% of subjects treated with aripiprazole (n = 21) [21]. However, response rates found in the context of manic or euthymic phases of BD are difficult to compare.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, aripiprazole augmentation to mood stabilizers could represent a promising treatment in BD patients with comorbid OCD, but so far, few data are available. Indeed, only one clinical trial was conducted to study the effects of aripiprazole as an adjuvant treatment for obsessive-compulsive (OC) symptoms in the manic phase of BD, showing good efficacy of aripiprazole in the treatment of OC symptoms [21]. To our knowledge, there are no studies that investigated the efficacy on OC symptoms of aripiprazole augmentation to mood stabilizers in euthymic BD-OCD patients.…”

Section: Introductionmentioning

confidence: 99%

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Aripiprazole Augmentation to Mood Stabilizers for Obsessive-Compulsive Symptoms in Bipolar Disorder

et al. 2020

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Background and Objectives: Aripiprazole is a first-line agent in the treatment of bipolar disorder (BD) and available data demonstrates its efficacy on clinical symptoms in serotonin reuptake inhibitors-resistant obsessive-compulsive disorder (OCD) patients. Therefore, aripiprazole augmentation to mood stabilizers could represent a promising treatment in BD patients with comorbid OCD. The study examined the efficacy and safety of aripiprazole added to lithium or valproate for the treatment of obsessive-compulsive (OC) symptoms in euthymic BD patients with comorbid OCD. Materials and Methods: This is a 12-week prospective observational study. The efficacy of aripiprazole on OC symptoms was assessed through the mean change of Yale–Brown Obsessive-Compulsive (YBOCS) total score. Tolerability was assessed with the Utvalg for Kliniske Undersogelser (UKU) side effect scale and by reporting adverse events. Results: A total of 70 patients were included in the analyses. The withdrawal rate was 21.4%, mainly due to adverse events. Mean ± SD final aripiprazole dose was 15.2 ± 5.3 in the completer sample (N = 55). The Y-BOCS mean score decreased from 24.0 ± 4.1 at baseline to 17.1 ± 4.3 at 12 weeks. Treatment response rate (Y-BOCS reduction ≥ 35%) was 41.8%, while partial response rate (Y-BOCS reduction greater than 25% but less than 35% from baseline) accounted for the other 18.2% of patients. Overall, 91.4% of completers had at least 1 adverse effect (tremor, tension/inner unrest, reduced duration of sleep, akathisia). No significant differences emerged comparing aripiprazole efficacy and tolerability between patients treated with lithium or valproate. Conclusion: Our findings show that aripiprazole addition to lithium or valproate can reduce OC symptoms in real-world BD euthymic patients.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Aripiprazole Augmentation to Mood Stabilizers for Obsessive-Compulsive Symptoms in Bipolar Disorder

et al. 2020

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“…Relatos de caso também sugerem que o aripiprazol pode ser efetivo como adjuvante na fase de manutenção [21][22][23]. Um estudo duplo-cego, de 8 semanas, com uma amostra de 56 pacientes, comparando a redução dos SOC em pacientes no estado maníaco que receberam aripiprazol ou placebo, relatou que os pacientes tratados com aripiprazol apresentaram redução 34% maior dos SOC medidos pela Yale-Brown Obsessive Compulsive Scale (Y-BOCS) [24].…”

Section: Antipsicóticos Na Comorbidadeunclassified

Comorbidade entre transtorno bipolar e transtorno obsessivo-compulsivo: aspectos epidemiológicos, clínicos e terapêuticos.

Silva¹,

Calil

Boaventura

et al. 2022

Debates em Psiquiatria

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Introdução: O transtorno bipolar (TB) e o transtorno obsessivo-compulsivo (TOC) são altamente comórbidos. Esta comorbidade está associada a impacto clínico significativo. Este artigo revisa os dados disponíveis sobre aspectos epidemiológicos, características clínicas e opções de tratamento da comorbidade TB-TOC. Métodos: Foi realizada revisão bibliográfica não sistemática na base de dados PUBMED, no idioma inglês. As seguintes palavras-chave foram incluídas na busca: obsessive-compulsive disorder, bipolar disorder, comorbidity. Resultados: Entre as amostras de pacientes com TB, a prevalência de TOC comórbido foi estimada em cerca de 17%. Entre as amostras de pacientes com TOC, a prevalência de TB foi estimada em, aproximadamente, 18%. Os dados sobre a validade diagnóstica da comorbidade são limitados. Os pacientes com TB-TOC parecem apresentar curso episódico dos sintomas obsessivo-compulsivos (SOC) com maior frequência do que os pacientes com TOC sem TB. A comorbidade parece estar associada à maior número total de episódios depressivos e à ocorrência mais frequente de comportamentos suicidas. Conteúdos obsessivos de simetria, agressão, religiosidade e acumulação parecem ser mais frequentes em pacientes com TB-TOC. O uso de estabilizadores do humor é a principal estratégia de tratamento. Conclusão: A prevalência da comorbidade parece ser relevante. O TB-TOC pode estar associado à caracteristicas clínicas particulares. Os dados sobre a validade diagnóstica da comorbidade são inconclusivos. A estabilização do humor é o primeiro objetivo no manejo clínico.

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“…26 There is no standard cutoff point for Y-BOCS. A decrease of more than 35% in Y-BOCS was considered a significant response rate in our study based on analysis of data in previous similar studies, 27,28 although in one study on resistant OCD patients, more than 25% decrease in Y-BOCS was chosen as the cutoff point for treatment response. 20 Adverse effects of the medications were also registered.…”

Section: Measurementsmentioning

confidence: 99%

Pregabalin augmentation for resistant obsessive–compulsive disorder: a double-blind placebo-controlled clinical trial

Mowla

Ghaedsharaf

2019

CNS Spectr.

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Background and objective.Glutamate dysfunction has been shown to be associated with pathophysiology of obsessive–compulsive disorder (OCD). Our objective is to survey the effects of pregabalin (a glutamate-modulating agent) as an augmenting treatment for resistant OCD.Patients and methods.In this 12-week double-blind placebo-controlled clinical trial, 56 patients with resistant OCD were randomly allocated to receive either pregabalin or placebo plus their current medication (sertraline). Yale–Brown Obsessive Compulsive Scale (Y-BOCS) was used to evaluate the outcomes. Adverse effects were also registered.Results.Of the 56 patients with resistant OCD who were randomly allocated in 2 groups of pregabalin (n = 28) and placebo group (n = 28), 42 patients (22 in pregabalin group and 20 in placebo group) completed the trial. Throughout the trial, the mean score decreased from 26.13± 7.03 to 8.81 ± 3.47 in the pregabalin group (p < 0) and from 26.85 ± 4.34 to 17.63 ± 4.22 in the placebo group (p < 0). At the end of trial, 16 (57.14%) patients in the pregabalin group and 2 (7.14%) patients in the placebo group showed more than 35% decline in YBOCS (p < .01). The pregabalin group showed good tolerability and safety.Conclusions.Our study revealed that pregabalin, as an augmenting medication, is more effective than placebo in the treatment of patients with resistant OCD.

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Aripiprazole as an adjuvant treatment for obsessive and compulsive symptoms in manic phase of bipolar disorder: A randomized, double-blind, placebo-controlled clinical trial

Cited by 16 publications

References 38 publications

Aripiprazole Augmentation to Mood Stabilizers for Obsessive-Compulsive Symptoms in Bipolar Disorder

Aripiprazole Augmentation to Mood Stabilizers for Obsessive-Compulsive Symptoms in Bipolar Disorder

Comorbidade entre transtorno bipolar e transtorno obsessivo-compulsivo: aspectos epidemiológicos, clínicos e terapêuticos.

Pregabalin augmentation for resistant obsessive–compulsive disorder: a double-blind placebo-controlled clinical trial

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