Aripiprazole in Children and Adolescents with Schizophrenia

Argyriou, Evangelia; Petroggona, M.; Charitaki, Stella; Belivanaki, Maria; Giannakopoulos, George; Kolaitis, Gerasimos

doi:10.2174/2211556011201020117

Cited by 2 publications

(3 citation statements)

References 23 publications

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“…This case is of importance given the increasing frequency of pediatric patients on stimulant medications with atypical antipsychotics. Aripiprazole, an atypical antipsychotic approved for treatment of several common psychiatric conditions in pediatric patients, has gained popularity for its favorable risk profile vs typical antipsychotics . It is a partial dopamine agonist with high affinity for the D2 dopamine receptor where partial agonism is thought to limit the risk of extrapyramidal symptoms .…”

Section: Discussionmentioning

confidence: 99%

“…It is a partial dopamine agonist with high affinity for the D2 dopamine receptor where partial agonism is thought to limit the risk of extrapyramidal symptoms . However, a 2012 meta‐analysis showed extrapyramidal symptoms as the most common adverse event associated with aripiprazole in children and adolescents . A 2016 meta‐analysis assessing evidence for acute extrapyramidal symptoms associated with aripiprazole in children and adolescents revealed a mean extrapyramidal symptoms incidence of 17.1%, with a mean dystonia incidence of 4.8% .…”

Section: Discussionmentioning

confidence: 99%

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Acute masseter dystonia in a pediatric patient receiving aripiprazole and methylphenidate following induction of general anesthesia

LeRiger

Williams

Duncan-Wiebe

et al. 2017

Pediatric Anesthesia

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An 11-year-old male receiving aripiprazole, methylphenidate, and clonidine developed acute masseter dystonia inhibiting tracheal intubation after induction of general anesthesia with propofol and rocuronium. Following emergence, he had trismus and jaw discomfort. Psychiatry consultation suspected an acute dystonic reaction, so diphenhydramine was administered intravenously which resolved symptoms. We suspect chronic aripiprazole and methylphenidate usage combined with propofol administration in the short-term absence of methylphenidate made this patient susceptible to dystonic reactions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Acute masseter dystonia in a pediatric patient receiving aripiprazole and methylphenidate following induction of general anesthesia

LeRiger

Williams

Duncan-Wiebe

et al. 2017

Pediatric Anesthesia

View full text Add to dashboard Cite

show abstract

“…For example, the EPAR summary [ 1 ] suggests that men have a higher risk of developing acute dystonia. Argyriou et al [ 44 ] and EMA [ 1 ] mention a positive dose–response relationship in children and adolescents: a higher dose of aripiprazole is supposed to increase the incidence of EPS. For this reason, the FDA [ 2 ] recommends a daily dose of 10 mg (with a maximum of 30 mg/day).…”

Section: Discussionmentioning

confidence: 99%

Aripiprazole and Acute Extrapyramidal Symptoms in Children and Adolescents: A Meta-Analysis

et al. 2016

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BackgroundBoth the US FDA and the European Medicines Agency (EMA) have approved aripiprazole for use in adolescents for specific indications. Given the assumed favorable side-effect profile of aripiprazole, its use in children and adolescents has increased for both official and off-label indications (anxiety disorders, eating disorders, personality disorders). However, several cases of children and adolescents with new-onset extrapyramidal symptoms (EPS) after commencing treatment with aripiprazole have been reported, and a more systematic appraisal of this possible risk is lacking.ObjectiveWe conducted a systematic review and a meta-analysis to assess the evidence for acute EPS (acute dystonia, akathisia, Parkinsonism) associated with the use of aripiprazole in children and adolescents.MethodWe searched the MEDLINE and Embase databases (2003–10 April 2016) for clinical trials in pediatric patients (aged 0–18 years) using the keywords ‘aripiprazole’ (regardless of the formulation) and ‘extrapyramidal symptoms’. We evaluated the abstracts of papers using the following exclusion criteria: (1) study design: case report, letter to the editor, editorial, or poster presentation data; (2) unrelated PICOS (population, intervention, comparators, outcomes, study) structure. We performed a meta-analysis, in which we used effect sizes with 95 % confidence intervals (CIs). To examine the homogeneity of the effect size distribution, we used a Q-statistic. When we observed heterogeneity in effect sizes, we assessed the possible influence of moderator variables (age and sex, mean dose, study duration, and method of measuring EPS incidence) and evaluated the suitability of either a fixed or a random model. Finally, we assessed the incidence of EPS in children and adolescents treated with aripiprazole compared with placebo.ResultsAn initial search via PubMed and Embase yielded 328 hits. A manual search of the reference lists of review papers revealed seven additional relevant articles. We included 41 studies, with 2114 pediatric patients, in the meta-analysis. For the analysis of the mean incidence of EPS, data were provided by 24 studies, with a total of 1446 pediatric patients. Meta-analysis revealed a mean EPS incidence of 17.1 % (95 % CI 0.128–0.223). In terms of the incidence of various extrapyramidal side effects, overall, no significant effects of age, sex, mean dose, study duration, or measuring method could be demonstrated. The side effects ‘EPS’, ‘parkinsonism’, and ‘tremor’ were significantly more common in children and adolescents treated with aripiprazole than in those treated with placebo.ConclusionOur meta-analysis provides evidence for a non-negligible incidence of acute EPS in children and adolescents treated with aripiprazole. Although the study has several limitations and further investigation is needed, these findings may help clinicians make more balanced treatment choices and more closely monitor the use of this drug in youth.Electronic supplementary materialThe online version of this article (doi:10.1007/s40...

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Aripiprazole in Children and Adolescents with Schizophrenia

Cited by 2 publications

References 23 publications

Acute masseter dystonia in a pediatric patient receiving aripiprazole and methylphenidate following induction of general anesthesia

Acute masseter dystonia in a pediatric patient receiving aripiprazole and methylphenidate following induction of general anesthesia

Aripiprazole and Acute Extrapyramidal Symptoms in Children and Adolescents: A Meta-Analysis

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