Aripiprazole for Patients with Schizophrenia and Schizoaffective Disorder: An Open-Label, Randomized, Study Versus Haloperidol

Abstract

Introduction: Aripiprazole, a dopamine D2 receptor partial agonist, has also partial agonist activity at serotonin (5-HT)1A receptors and antagonist activity at 5-HT2A receptors.Methods: In this 8-week, multicenter, randomized, parallel-group, open-label, flexible-dose study, patients diagnosed with schizophrenia or schizoaffective disorder were randomized to aripiprazole 15–30 mg/day or haloperidol 10–15 mg/day.Results: Patients treated with both aripiprazole and haloperidol improved from baseline in Positive and Negative Syndrome Scale total, positive, and negative scores as well as in Clinical Global Impressions scores (all P<.001). At the end of the study, the percentage of patients classified as responders—according to ≥40% reduction in the Positive and Negative Syndrome Scale negative subscale score—was significantly higher in the aripiprazole group (20%) than in the haloperidol group (0%) (P<.05). Additionally, a higher number of patients receiving haloperidol required more anticholinergic medications (P<.001) than aripiprazole-treated patients, whereas more aripiprazole (45.5%) than haloperidol-treated patients (12.9%) required benzodiazepines (P=.002). At endpoint, rates of preference of medication were higher in the aripiprazole group (63.2%) than in the haloperidol group (21.7%), as expressed by patients and caregivers (P=.001).Conclusion: Aripiprazole and haloperidol had similar efficacy in terms of reduction of overall psychopathology. Although aripiprazole has been demonstrated to be superior concerning negative symptoms and in terms of tolerability (extrapyramidal symptoms) and preferred by patients and caregivers than haloperidol, significantly more aripiprazole-treated patients required benzodiazepines.

Effect of psychotropic drug treatment on sterol metabolism

“…Haloperidol, a conventional antipsychotic drug, and aripiprazole an atypical antipsychotic drug, are prescribed for SZ and BPD, while trazodone is prescribed for MDD and insomnia (de Oliveira et al, 2009; Docherty et al, 2010; Roth et al, 2011; Saletu-Zyhlarz et al, 2003). The piperazine ring in aripiprazole and trazodone has raised some interest because of similarities with known DHCR7 inhibitors (Hall et al, 2013).…”

Use of Aripiprazole Long Acting Injection in Negative Symptoms of Schizophrenia

“…It is unique in its mechanism of action due to its partial agonism at dopamine D2 receptors compared to other second-generation antipsychotic drugs. The efficacy of oral aripiprazole in treatment of schizophrenia is well established [ 13 , 14 ]. Aripiprazole is known to improve both positive and negative symptoms of schizophrenia [ 15 ].…”

Um incansável pesquisador em psicofarmacologia e um filósofo padrão-ouro: o cientista e humanista João Romildo Bueno (1938-2019)

“…5 Vale destacar que o professor Romildo parti cipou como investi gador nos programas de desenvolvimento de vários agentes psicofarmacológicos lançados nos últi mos anos. 6,7 Durante o ano passado, ele esteve envolvido com muito entusiasmo em um estudo de longo prazo que acompanhou de perto por mais de duas décadas. 8 Por fi m, não podemos deixar de mencionar o papel fundamental exercido pelo Professor Romildo no desenvolvimento de nossa associação, a ABP, desde sua concepção.…”