A systematic review of quality of life and weight gain-related issues in patients treated for severe and persistent mental disorders: focus on aripiprazole

Abstract

Aripiprazole is a relatively novel second-generation antipsychotic belonging to the chemical class of benzisoxazole derivatives and is characterized by a unique pharmacological profile which suggests that the drug acts as a dopamine-serotonin system stabilizer. Whereas all previously available antipsychotics are antagonists at D2 receptors, aripiprazole is the only available partial agonist at these receptors. Thus, it has been suggested that aripiprazole could be associated with a relatively neutral impact on bodyweight, possibly reducing risks of a detrimental impact on the quality of life that often complicates management for a large number of patients diagnosed with severe and persistent mental disorders (SPMDs) treated chronically with antipsychotic medications. However, data from short- and long-term reviewed studies indicate that the prevalence rate of clinically relevant weight gain during therapy with this drug is similar to that occurring during treatments with other antipsychotic agents, either typical or atypical. Moreover, information on the impact of aripiprazole therapy on the quality of life of patients diagnosed with SPMDs is scarce and characterized by conflicting results. Given these results, further, large, well-designed studies are needed before confirming potential advantages of aripiprazole over first-generation antipsychotics and other SGAs.

Comparative study of treatment continuation using second-generation antipsychotics in patients with schizophrenia or schizoaffective disorder

“…Aripiprazole acts as a partial agonist at dopaminergic D 2 8 and serotoninergic 5-HT 1A 9 receptors and as an antagonist at 5-HT 2A receptors 10. It also shows low affinity for histaminergic H 1 and muscarinic cholinergic receptors 2,10. Because of this pharmacological profile, it has a low propensity to cause extrapyramidal symptoms, weight gain, metabolic disruption, hyperprolactinemia, sedation, or prolongation of the QT interval,10,11 and has little effect on psychosocial functioning 12.…”

Retrospective Review of Weight Gain with Atypical Antipsychotics at GMH and COCMHC

“…These patients were on different atypical antipsychotics, such as aripiprazole (Abilify), ziprasidone (Geodon), or risperidone (Risperdal), which have been shown to cause minimal weight gain in comparison to those studied [10,16,17]. However, the patient population studied showed an average weight gain of 20.84 pounds when using either of these drugs.…”

Role of aripiprazole in treatment-resistant schizophrenia

“…Other groups have found similar tendencies towards weight gain for aripiprazole and other antipsychotics, such as perphenazine in treatment-resistant patients37 and risperidone in patients termed “chronic” or suffering from their first schizophrenic episode 38. A critical review concludes that the potential advantages of aripiprazole with respect to weight changes are still conflicting and need confirmation in a larger sample 39. In a clinical practice analysis, aripiprazole, quetiapine, and amisulpride did not carry an increased risk of diabetes mellitus.…”