Aripiprazole in the treatment of Alzheimer's disease

Abstract

In randomized placebo-controlled clinical trials, aripiprazole shows modest efficacy in the treatment of AD-related psychosis. Neuropsychiatric symptoms alleviated were predominantly psychotic features and agitation. In individual trials, aripiprazole was generally well tolerated, serious side effects were seldom reported and included accidental injury and somnolence. Meta-analyses however demonstrated increased mortality as a class effect for atypical, but also for typical antipsychotics. No increased cardiovascular outcomes, cerebrovascular accidents, increased appetite or weight gain were demonstrated in meta-analyses for aripiprazole-treated patients with psychosis of dementia. Aripiprazole was found to induce sedation. Aripiprazole should only be used in selected patient populations resistant to non-pharmacological treatment with persisting or severe psychotic symptoms and/or agitation, and in which symptoms lead to significant morbidity, patient suffering and potential self-harm. The indication for continuing treatment should be revised regularly.

Highly sensitive ligand-binding assays in pre-clinical and clinical applications: immuno-PCR and other emerging techniques

“…[24][25][26] Owing to their generally higher target specificity, such bulky biological molecules provide novel therapeutic potentials, as compared to classical small molecule drugs, 27 such as the blockbusters Fluticasone, 28 Rosuvastine, 29,30 or Aripiprazole. 31 However, the development of Biologics brings with it multiple challenges when it comes to bioanalytical sample testing support for tracing these compounds or quantifying the response of their endogenous interaction partners. [32][33][34] While quantification of small-molecule drugs and metabolites can often be achieved by mass spectrometry (MS)-based methods, these techniques are usually not well suited for studying Biologics.…”

Treatment and Management of Dementia Due to Alzheimer’s Disease

“…Worsened cognitive impairment (0.8 point drop on Mini-Mental State Examination), orthostatic hypotension, tachycardia, decreased seizure threshold, tremor, and gastrointestinal disturbances [69] Special points Extrapyramidal symptoms, weight gain, prolactin elevation, cardiovascular adverse effects, and electrocardiogram changes equal to placebo. Mintzer et al reports mortality rates appear to be dose related: placebo, 3 %; 2 mg dose, 3 %; 5 mg dose, 2 %; and 10 mg dose, 7 % but deemed not statistically significant [70].…”

Psychosis in Later Life

“…A recent review concluded that aripiprazole does have modest efficacy in treating psychosis in this population and is generally well tolerated, with few serious side effects reported. 110 In sum, while atypical antipsychotics do appear to have some benefit in this context, they should be used cautiously because of the side effects associated with their use and the mixed results regarding their efficacy. Alternatively, there has been growing interest in the N-methyl-D-aspartate receptor antagonist memantine for treating behavioral problems in Alzheimer's patients.…”