A meta-analysis of efficacy and safety of aripiprazole in adult and pediatric bipolar disorder in randomized controlled trials and observational studies

Meduri, M.; Gregoraci, Giorgia; Baglivo, Valentina; Balestrieri, Matteo; Isola, Miriam; Brambilla, Paolo

doi:10.1016/j.jad.2015.11.033

Cited by 20 publications

(18 citation statements)

References 51 publications

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“…Comparison to two recent meta-analyses (Brown et al, 2013;Meduri et al, 2016), our study provided more information on the analysis of adverse reactions and preventive efficacy as shown by relapse rates from bipolar mania to bipolar depression. The more recent search dates and stricter inclusion criteria (only RCTs in this meta-analysis) mean that the results of this meta-analysis are more up-to-date compared to the previous reports.…”

Section: Accepted Manuscript Discussionmentioning

confidence: 90%

“…In addition, the dose-dependent responses and adverse reactions to antipsychotic drugs should be considered with caution; however, aripiprazole has been approved for the treatment of BD in pediatric patients by the FDA in the USA and the EMA in the EU for its efficacy and safety. Furthermore, the previous two studies (Brown et al, 2013;Meduri et al, 2016) also included above two studies into their analyses. However, despite the apparent good tolerability, the results of this meta-analysis should be interpreted with caution for application in clinical practice in pediatric patients.…”

Section: Accepted Manuscript Discussionmentioning

confidence: 99%

“…Two previous meta-analyses (Brown et al, 2013;Meduri et al, 2016) investigated the efficacy or safety profile of aripiprazole. Brown et al (Brown et al, 2013) discussed the efficacy and adverse reactions in BD; however, the authors only addressed the effects of treatment with regards to episodes of mania without considering the depression or maintenance phase, and their search only included trials before 2013.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Furthermore, previous analysis of adverse reactions have contained less than three trials, precluding the ability to make definitive conclusions (Davey et al, 2011). Another more recent meta-analysis (Meduri et al, 2016) included 16 trials and observational studies of BD, however their analysis focused on the severity of changes in mania and response rates, and did not include subgroup analyses for depression, remission rates or relapse rates. Following these two meta-analyses, another two preliminary meta-analyses have also been published (Dundar et al, 2016;Lindstrom et al, 2017).…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…In addition, the reference lists of review articles relevant to this topic were manually searched to identify potentially eligible papers (Arbaizar et al, 2009;Biederman et al, 2005;Brown et al, 2013;Fountoulakis et al, 2009;Fountoulakis et al, 2011;McKeage, 2014;Meduri et al, 2016;Miura et al, 2014;Perlis, 2007;Perlis et al, 2006;Scherk et al, 2007;Smith et al, 2007;Taylor, 2003;Vieta et al, 2010;Yatham et al, 2013;Yildiz et al, 2015).…”

Section: Accepted Manuscriptmentioning

confidence: 99%

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Efficacy, safety and tolerability of aripiprazole in bipolar disorder: An updated systematic review and meta-analysis of randomized controlled trials

Tseng²,

Stubbs

et al. 2017

Progress in Neuro-Psychopharmacology and Biological Psychiatry

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-keung Chow , Efficacy, safety and tolerability of aripiprazole in bipolar disorder: An updated systematic review and meta-analysis of randomized controlled trials. The address for the corresponding author was captured as affiliation for all authors. Please check if appropriate. Pnp(2017Pnp( ), doi: 10.1016Pnp( /j.pnpbp.2017 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.A C C E P T E D M A N U S C R I P T Aripiprazole was associated with lower relapse rates in bipolar mania when used in combination versus a placebo in maintenance therapy (odds ratio: 0.522, p<0.029). ACCEPTED MANUSCRIPT A C C E P T E D M A N U S C R I P TAripiprazole was also associated with higher levels of high density lipoprotein, lower dropout rates, but no difference in extrapyramidal symptoms in the maintenance phase versus a placebo or in comparison with other medications (haloperidol or lithium). Our results suggest that aripiprazole is effective and safe in treating bipolar mania. Further trials are necessary to evaluate the efficacy and tolerability versus other medications.

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Section: Accepted Manuscript Discussionmentioning

confidence: 90%

Section: Accepted Manuscript Discussionmentioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 99%

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Efficacy, safety and tolerability of aripiprazole in bipolar disorder: An updated systematic review and meta-analysis of randomized controlled trials

Tseng²,

Stubbs

et al. 2017

Progress in Neuro-Psychopharmacology and Biological Psychiatry

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Efficacy and acceptability of pharmacological, psychosocial, and brain stimulation interventions in children and adolescents with mental disorders: an umbrella review

et al. 2021

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Top‐tier evidence on the safety/tolerability of 80 medications in children/adolescents with mental disorders has recently been reviewed in this journal. To guide clinical practice, such data must be combined with evidence on efficacy and acceptability. Besides medications, psychosocial interventions and brain stimulation techniques are treatment options for children/adolescents with mental disorders. For this umbrella review, we systematically searched network meta‐analyses (NMAs) and meta‐analyses (MAs) of randomized controlled trials (RCTs) evaluating 48 medications, 20 psychosocial interventions, and four brain stimulation techniques in children/adolescents with 52 different mental disorders or groups of mental disorders, reporting on 20 different efficacy/acceptability outcomes. Co‐primary outcomes were disease‐specific symptom reduction and all‐cause discontinuation (“acceptability”). We included 14 NMAs and 90 MAs, reporting on 15 mental disorders or groups of mental disorders. Overall, 21 medications outperformed placebo regarding the co‐primary outcomes, and three psychosocial interventions did so (while seven outperformed waiting list/no treatment). Based on the meta‐analytic evidence, the most convincing efficacy profile emerged for amphetamines, methylphenidate and, to a smaller extent, behavioral therapy in attention‐deficit/hyperactivity disorder; aripiprazole, risperidone and several psychosocial interventions in autism; risperidone and behavioral interventions in disruptive behavior disorders; several antipsychotics in schizophrenia spectrum disorders; fluoxetine, the combination of fluoxetine and cognitive behavioral therapy (CBT), and interpersonal therapy in depression; aripiprazole in mania; fluoxetine and group CBT in anxiety disorders; fluoxetine/selective serotonin reuptake inhibitors, CBT, and behavioral therapy with exposure and response prevention in obsessive‐compulsive disorder; CBT in post‐traumatic stress disorder; imipramine and alarm behavioral intervention in enuresis; behavioral therapy in encopresis; and family therapy in anorexia nervosa. Results from this umbrella review of interventions for mental disorders in children/adolescents provide evidence‐based information for clinical decision making.

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The evidence-based choice for antipsychotics in children and adolescents should be guaranteed

Putignano

Clavenna

Reale

et al. 2019

Eur J Clin Pharmacol

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A meta-analysis of efficacy and safety of aripiprazole in adult and pediatric bipolar disorder in randomized controlled trials and observational studies

Cited by 20 publications

References 51 publications

Efficacy, safety and tolerability of aripiprazole in bipolar disorder: An updated systematic review and meta-analysis of randomized controlled trials

Efficacy, safety and tolerability of aripiprazole in bipolar disorder: An updated systematic review and meta-analysis of randomized controlled trials

Efficacy and acceptability of pharmacological, psychosocial, and brain stimulation interventions in children and adolescents with mental disorders: an umbrella review

The evidence-based choice for antipsychotics in children and adolescents should be guaranteed

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