Efficacy and Safety of Aripiprazole Once-Monthly in the Maintenance Treatment of Bipolar I Disorder

Calabrese, Joseph R.; Sanchez, Raymond; Jin, Na; Amatniek, Joan; Cox, Kevin; Johnson, Brian R.; Perry, Pamela; Hertel, P.; Such, Pedro; Salzman, Phyllis M.; McQuade, Robert D.; Nyilas, Margaretta; Carson, William H.

doi:10.4088/jcp.16m11201

Cited by 119 publications

(60 citation statements)

References 34 publications

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“…Recent data suggest that asenapine (level 2)374 is effective in preventing both manic and depressive episodes, and thus is recommended as a first‐line treatment. Finally, aripiprazole oral (level 2)375, 376 or once monthly (level 2)377 is also recommended as a first‐line monotherapy in view of its efficacy in preventing any mood or manic episode as well as its safety/tolerability profile, although it has not been shown to be effective in preventing depression.…”

Section: Maintenance Therapy For Bipolar Disordermentioning

confidence: 99%

“…If ineffective, long‐acting injectable medications should be offered. Risperidone long‐acting injectable monotherapy383 or adjunctive therapy (level 2)384 once every 2 weeks or aripiprazole once‐monthly injectable monotherapy (level 2)377 has been shown to be effective in preventing relapse of mood episodes in patients with BD.…”

Section: Maintenance Therapy For Bipolar Disordermentioning

confidence: 99%

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Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third‐ line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment‐emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second‐ line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence‐based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first‐line treatments for acute mania. First‐line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be considered first‐line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe.

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Section: Maintenance Therapy For Bipolar Disordermentioning

confidence: 99%

Section: Maintenance Therapy For Bipolar Disordermentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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“…BD can be very difficult to manage because of its highly recurrent nature. Long-term drug treatment is necessary to prevent disease relapse [16]. The chronic nature of the disorder and the negative consequences of persistent symptoms underline the need for effective long-term treatment.…”

Section: Paliperidone Lai and Aripiprazole Lai Plasma Level Monitorinmentioning

confidence: 99%

“…Mean PANSS scale values decreased significantly during the study starting from T 1 (T 0 72. 16 toms) showed the following trend: the mean scores of the general psychopathology subscale decreased from T 0 (36.25 ± 6.53 SD) to T 12 (26.43 ± 5.34 SD), with a significant reduction (p < 0.001) starting from T 0 vs. T 2 ; the reduction of the positive subscale scores starting from T 0 vs. T 2 (T 0 = 17.12 ± 6.49 SD; T 12 = 9.25 ± 2.48 DS) was significant as well.…”

Section: Paliperidone Palmitatementioning

confidence: 99%

Paliperidone LAI and Aripiprazole LAI Plasma Level Monitoring in the Prophylaxis of Bipolar Disorder Type I with Manic Predominance

et al. 2020

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Introduction The objective of this study was the evaluation of utility of plasma level monitoring in the clinical stabilizing efficacy and tolerability of paliperidone palmitate (PP) vs. aripiprazole monohydrate (AM) in bipolar disorder I (BD I) with manic predominance. Methods Fifty-six outpatients of both sexes, age ranging from 18 to 65 years, affected by BD I with manic predominance, orally treated and stabilized after acute episode for at least 2 weeks with paliperidone or aripiprazole (n=31, paliperidone; n=25, aripiprazole) underwent a prospective observational study of switching to the corresponding long-acting injection (LAI) on the basis of clinical evaluation. The efficacy and tolerability of the 2 treatments were assessed by BPRS, PANSS, HAMD21, and MRS rating scales and a check list every month for 12 months. Drug plasma levels determinations (PLs) were performed at the same times. Results A good clinical stability and tolerability of both drugs were reported. Lower mean PLs of PP showed a positive effect on depressive symptoms. AM PLs variability was associated with greater instability of manic symptoms whereas intermediate PLs seem to have more influence on depressive symptomatology. Discussion PLs drug monitoring has been proven to be useful, and further investigations to identify optimal therapeutic ranges for LAI formulations are needed.

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“…Calabrese et al [47] conducted a double-blind, placebo-controlled, 52-week randomized withdrawal study on 266 patients with BP-I currently experiencing a manic episode stabilized sequentially on oral aripiprazole and AOM 400 mg and then randomized to AOM 400 mg or placebo. AOM 400 treatment considerably delayed the time to recurrence of any mood episode and significantly fewer patients showed recurrence of any mood episode with AOM 400 compared with placebo, with the effects observed mainly on manic episodes.…”

Section: The Use Of the Sga-lais In The Treatment Of Bdmentioning

confidence: 99%

Second Generation Long-Acting Antipsychotics in the Treatment of Bipolar Disorder: A Clinical Viewpoint

Berardis¹,

Fornaro²,

Orsolini³

et al. 2018

Bipolar Disord

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Bipolar Disorder (BD) is a severe, chronic and disabling condition. The gold standard of treatment is lithium, but the introduction of Second Generation Long-Acting Antipsychotics (SGA-LAIs) has been addressed several problems in the administration of oral SGAs in BD such as the patient's adherence to the treatment. The aim of this commentary was to provide an overview of the use of SGA-LAIs in the treatment of BD. All considered, the use of SGA-LAIs such as Risperidone Long-Acting and Aripiprazole Long-Acting may have an important impact on the maintenance treatment of BD both in monotherapy or in association with mood stabilizers. In our opinion, the treatment with a SGA-LAI should be initiated as early as possible in BD, especially when non-adherence is suspected. Moreover, as personality disorders (PD) and BD may often coexist, it is worthy to note that the PD-BD comorbidity may further decrease treatment adherence and, therefore, we believe that the early use of a SGA-LAI both in monotherapy or in association with mood stabilizers may dramatically improve the compliance and the overall outcomes in such cases. However, he safety profile should be always kept in mind when choosing an SGA-LAI in the treatment of BD.

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Efficacy and Safety of Aripiprazole Once-Monthly in the Maintenance Treatment of Bipolar I Disorder

Cited by 119 publications

References 34 publications

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Paliperidone LAI and Aripiprazole LAI Plasma Level Monitoring in the Prophylaxis of Bipolar Disorder Type I with Manic Predominance

Second Generation Long-Acting Antipsychotics in the Treatment of Bipolar Disorder: A Clinical Viewpoint

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