Magazine article Clinical Psychiatry News

Aripiprazole Benefits Are Sustained over Time. (Superior Side Effect Profile)

Magazine article Clinical Psychiatry News

Aripiprazole Benefits Are Sustained over Time. (Superior Side Effect Profile)

Article excerpt

NEW YORK -- Two extended clinical trials have shown that the benefits of aripiprazole, the newest antipsychotic, endure and perhaps increase over time, Dr. W Gordon Frankle said at a conference on schizophrenia sponsored by Columbia University.

Its principal advantage over other atypical agents remains a superior side effect profile; no apparent difference in efficacy exists.

"We can expect aripiprazole (Abilify) will be effective for many but not all patients with schizophrenia. It's not the new clozapine (Clozaril)," said Dr. Frankle of the university.

In a 26-week trial, 310 stable patients were randomized to receive 13 mg/day of aripiprazole or placebo. The treatment group was significantly slower to relapse than controls: By 60 days, 50% of controls showed signs of impending decompensation, while less than 40% of patients receiving aripiprazole had deteriorated to that point by the end of the study period.

Aripiprazole, at both 15 mg/day and 30 mg/day, demonstrated a response rate superior to haloperidol (Haldol) (10 mg/day) over the course of a 52-week trial: 52% of 853 aripiprazole-treated patients had improvements of 30% or greater in the Positive and Negative Symptom Scale (PANSS), compared with 44% of 430 treated with the conventional neuroleptic.

The two drugs reduced positive symptoms similarly and had a comparable impact on negative symptoms through the first half of the study. Negative symptoms continued to improve over the second half in the aripiprazole-treated patients, however, while they reached a plateau with haloperidol, Dr. Frankle said at the meeting cosponsored by the New York State Psychiatric Institute.

"Where it differentiates itself from other [atypical] medications is in side effects," he said.

Like other members of its class, aripiprazole has been significantly less likely to cause extrapyramidal side effects (EPS) than haloperidol. …

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