Transcript Aripiprazole in the treatment of acute manic or mixed episodes in

Aripiprazole in the
treatment of acute manic
or mixed episodes in
patients with bipolar I
disorder:
• Dosing could be reduced to 15
mg/day for Tolerability
• Aripiprazole : no significant
difference from placebo in change in
mean body weight
• not associated with elevated
prolactin or QTc prolongation
• fasting glucose,
• fasting insulin
• insulin
resistance index
• cholesterol
• triglycerides
• low-density
lipoprotein (LDL)
• LDL/HDL,
• Chol/HDL
treatment of an acute manic
episode for up to 12 weeks
Aripiprazole showed superior
levels of response and
tolerability to haloperidol
• Aripiprazole showed similar
efficacy to olanzapine for longterm treatment of acutely
psychotic and chronic, stable
schizophrenia patients,
• lower liability for weight gain or
increased lipid levels
Aripiprazole: initial clinical experience with 142
hospitalized psychiatric patients.
• daily dose, 16.1 +/- 6.2 mg
• body weight: 0.20 +/- 0.09 mg/kg
• aripiprazole is likely to be onsidered
for obese patients
• weight should be considered
short-term treatment of
schizophrenia
1. aripiprazole 15-30 mg is
as effective
2. haloperidol 10 mg/day
3. risperidone 6 mg/day
Aripiprazole
• quinolinone derivative
• high affinity for D2 , D3 receptors
• partial agonist action on 5-HT (1A)
receptors
• 5-HT (2A) receptors antagonist
• active metabolite: dehydroaripiprazole, = parent compound
dopamine D2 receptors
• peak plasma concentration=3 hours
• Steady-state plasma concentrations
are achieved by 14 days
• CYP3A4 and CYP2D6 transform it to
dehydroaripiprazole
• genetic polymorphism
• The drug is effective as early as the
first or second week of treatment.
• No additional therapeutic benefit
at the higher-than-recommended
dosages
induce weight gain
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clozapine and olanzapine.
TCA, mirtazapine come next
majority of the mood stabilizers.
The old antipsychotics seem to
involve less gain of weight.
• SSRI make lose weight in the first
weeks, but induce a moderate
weight gain on the long term.