Switching patients to aripiprazole from other antipsychotic agents: a multicenter randomized study

Abstract

Any of the three strategies evaluated can be used safely for switching patients to aripiprazole from antipsychotic monotherapy. Furthermore, patients' symptoms may continue to improve after switching to aripiprazole.

Long-Term Changes in Weight and Plasma Lipids during Maintenance Treatment with Ziprasidone

“…The three 6-week, medication-switch studies reported improvements in weight, BMI, and lipid profiles after therapeutic substitution of ziprasidone for olanzapine or risperidone (Weiden et al, 2003a). Short-term studies involving substitution of aripiprazole for olanzapine or risperidone also reported improvements in weight and BMI (Casey et al, 2003). However, these data did not establish whether these initial improvements could be sustained during long-term antipsychotic treatment.…”

“…In psychiatric populations, behavioral approaches may require more intensive and costly efforts to achieve even this level of weight reduction; however, few studies have addressed these issues (Brar et al, 2005;Menza et al, 2004). Weight reduction achieved with currently approved antiobesity drugs is similarly modest over the long term (approximately 5% of initial body weight (McMahon et al, 2000)), and these drugs may be associated with adverse effects that can limit their use in psychiatric patients (eg anxiety, insomnia, or anal leakage (Casey et al, 2003)). …”

“…While this may be a straightforward prevention strategy, it has not yet been established that switching from a higher-to a lower-risk antipsychotic medication can favorably affect long-term weight and lipid profiles. Previous studies, including the initial, 6-week, ziprasidone-switch studies, that suggest the short-term utility of this approach indicated statistically significant reductions in body weight and body mass index (BMI) over 6-weeks after a switch from risperidone or olanzapine to ziprasidone (Weiden et al, 2003a) or 8-weeks for aripiprazole (Casey et al, 2003). The ziprasidone-switch studies also detected significant reductions in nonfasting total plasma cholesterol and triglycerides in patients switched from both olanzapine and risperidone but not conventional antipsychotic drugs (Weiden et al, 2003a).…”

Aripiprazole in Children and Adolescents with Tourette's Disorder: An Open-Label Safety and Tolerability Study

“…This trend was a somewhat unexpected finding, because previous studies using aripiprazole monotherapy for treatment of schizophrenia in adults resulted in a modest weight loss over an 8-week study duration (Casey et al 2003). However, more recent studies involving children have suggested that children are more likely to experience metabolic effects of aripiprazole than adults (Correll 2008).…”

Diretrizes da Federação Mundial das Sociedades de Psiquiatria Biológica para o tratamento biológico da esquizofrenia. Parte 2: tratamento de longo prazo

“…Nas revisões e na maioria dos estudos, os APGs demonstraram apenas poucos efeitos benéficos na cognição (Cassens et al, 1990;Sharma, 1999), e muitas variações inapropriadas de dose, combinadas com SEP ou com medicação anticolinérgica concomitante, podem ter exercido um efeito negativo na cognição. Numa metanálise que incluiu estudos comparando os efeitos dos APGs àqueles do placebo ou da não-medicação apontaram ganhos modestos a moderados nos domínios cognitivos múltiplos para os APGs (Mishara e Goldberg, 2004).…”