This study shows that treatment-resistant OCD patients may benefit more from addition of quetiapine in comparison with aripiprazole, to their ongoing SRI therapy.

A comparative study on olanzapine and aripiprazole for symptom management in female patients with borderline personality disorder Objective: While Second Generation Antipsychotics (SGAs) have been shown, in some studies, to be helpful for amelioration of impulsiveness, aggressiveness and moodiness of patients with Borderline Personality Disorder (BPD), there are additional studies that believe that the evidence does not currently support effectiveness of SGAs for overall severity of borderline symptoms. In light of these conflicting reports, we conducted a trial to compare the efficacy and safety of olanzapine vs. aripiprazole with regard to management of BPD. Method: Twenty-four female inpatients, meeting the diagnosis of BPD according to the DSM-IV-TR criteria, were randomly entered into an 8-week parallel group, open-label study for random assignment to olanzapine or aripiprazole (n=12 in each group). The patients were selected from outpatients among clientele of two psychiatric clinics and also inpatients from female wards of Razi psychiatric hospital. Patients were excluded from the trial if any prominent co-morbid mental disorder was present. The primary outcome measure included the Brief Psychiatric Rating Scale (BPRS) for estimation of baseline psychopathology, clinical outcome and treatment response. In addition, the Buss-Durkee Hostility Inventory (BDHI) for the assessment of anger and hostility, and the Clinical Global Impressions-Severity Scale (CGI-S) for assessment of overall illness severity were used as secondary scales. Changes in mean total scores of the BPRS, CGI-S and BDHI were analyzed within each group by means of a paired t test and compared across the two groups by an unpaired t test. Statistical significance was defined as a 2-sided p value < or = to 0.05. In addition, analysis of effect size (ES) by calculation of Cohen's d was performed and recorded. Results: All of the patients remained in and completed the study. According to the findings olanzapine and aripiprazole reduced mean total score of the BPRS about 25.7% and 18.8% in their groups, and thus illustrated a significant improvement of primary outcome measure at the end of the trial, in comparison with baseline (p<0.01 and p<0.04, respectively). In addition, the mean total score of the BDHI improved around 15% with olanzapine and 12.2% with aripiprazole, which was again significant as regards the first drug (p<0.04), but not so concerning the second one (p<0.06). Significant changes in mean total scores of the CGI-S as well were observed in the olanzapine group with a reduction around 20.9% (p<0.03). Once more, improvement of the same scale by aripiprazole, even though remarkable (19.3%), was not statistically significant (p<0.07). The analysis of specific BPRS subscales in both groups revealed similar, significantly lower scores in anxiety, tension, depressive mood and hostility. In this regard, olanzapine showed appreciably better results on uncooperativeness and excitement, and aripiprazole showed superior efficacy as regards s...

Objectives: Current evidence supports the use of various second-generation antipsychotics for pharmacotherapy of schizophrenia. While in a systematic review, generally no difference in efficacy was found between atypical antipsychotics, other studies have found quetiapine less effective than aripiprazole. This article reviews the efficacy and tolerability of aripiprazole versus quetiapine in the context of recommended management strategies for schizophrenia. Method: Fifty female inpatients, meeting the diagnosis of schizophrenia, were randomly entered into two groups (n = 25 in each group) to participate in a 12-week, double-blind study for random assignment to quetiapine or aripiprazole. The primary outcome measures were Scale for Assessment of Positive Symptoms and Scale for Assessment of Negative Symptoms. The schedule for Assessment of Insight (SAI), Clinical Global Impressions Severity Scale (CGI-S) and the Simpson Angus Scale (SAS) were also used as secondary measures. Results: Both quetiapine and aripiprazole showed significant effectiveness in the improvement of positive symptoms. The effectiveness for negative symptoms was also noteworthy with both drugs, although not to a significant level during this study. In addition, significant improvement was found on assessment with CGI-S and SAI for quetiapine and aripiprazole. SAS did not show any important increment in extrapyramidal side effects at the end of the examination. Conclusion: According to the findings, quetiapine and aripiprazole had similar effectiveness and tolerability with respect to management of schizophrenia.

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INTRODUCTION: while around half of the patients with obsessive-compulsive disorder do not respond efficiently to current serotonin-reuptake inhibitors, the objective of the present study was to compare the effectiveness and safety of quetiapine versus aripiprazole in patients with obsessive-compulsive disorder, who had not responded effectively to fluvoxamine. METHOD: Forty-four patients with obsessive-compulsive disorder, who had not responded effectively to fluvoxamine at maximum dose (300 milligram per day) and duration (twelve weeks), were allocated randomly, in a double-blind trial, to receive quetiapine (n = 22) or aripiprazole (n = 22), in addition to their serotonin-reuptake inhibitor, for twelve weeks. While treatment response was evaluated by the Yale-Brown Obsessive-Compulsive Scale (YBOCS), as primary outcome scale, Clinical Global Impressions-Severity Scale (CGI-S), as well, had been used as an ancillary measure. RESULTS: 54.54% of patients in the quetiapione group (n = 12) and 27.27% of cases in the aripiprazole group (n = 6) responded partially to the abovementioned augmentation. According to the findings, the mean +/− SD baseline YBOCS' score, dropped from 31.18 +/−4.93 to 27.97+/−3.71 (p < 0.01), and 33.27 +/− 3.90 to 30.72+/−4.67 (p < 0.06), by quetiapine and aripiprazole, respectively. In this regard, no significant alteration with respect to CGI-S was evident in either of the aforementioned groups. CONCLUSION: This study indicated that patients with treatment-resistant obsessive-compulsive disorder could benefit more from adding quetiapine, in comparison with aripiprazole, to their ongoing serotonergic medication.