Unexpected effect of aripiprazole on nociceptive pain

Fei, Leonardo; Abrardi, Luca; Mediati, Rocco Domenico

doi:10.1177/2045125312451271

Cited by 12 publications

(8 citation statements)

References 6 publications

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“…Still, little is known about the somatic symptom targeting effects of aripiprazole. Several case reports showed nociceptive effects of aripiprazole [53,54], and a clinical trial reported that aripiprazole augmentation was effective to treat GI symptom related to MDD patients [55].…”

Section: Discussionmentioning

confidence: 99%

Additional Reduction of Residual Symptoms with Aripiprazole Augmentation in the Patients with Partially Remitted Major Depressive Disorder

Shin

Pae

Kwak

et al. 2021

Clin Psychopharmacol Neurosci

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Objective: Many patients with major depressive disorder (MDD) suffer from residual symptoms without achieving remission. However, pharmacologic options for residual symptoms of MDD have been limited. This study aimed to investigate benefit of aripiprazole augmentation in the treatment of residual symptoms in the patients with partially remitted MDD. Methods: We retrospectively analyzed the 8-week medical records of the patients. The enrolled patients did respond to treatment of antidepressant but were not remitted. The range of 17-item Hamilton Depression Rating Scale (HAMD) total score of the subjects were 8 to 15 points. All patients were currently taking antidepressants when they started aripiprazole. The primary endpoint was the mean change of Clinically Useful Depression Outcome Scale (CUDOS). Secondary endpoint measures were HAMD, Clinical Global Impression-severity (CGI-S) scores, Patient Health Questionnaire-15 (PHQ-15), Beck Anxiety Inventory (BAI), Perceived Deficit Questionnaire-depression (PDQ-D), Sheehan Disability Scale (SDS) and General Health Questionnaire/Quality of Life-12 (GHQ/QL-12). Results: A total of 134 medical records were analyzed. The changes of CUDOS, HAMD, CGI-S, BAI, PHQ-15, PDQ-D, SDS and GHQ/QL-12 from baseline to the endpoint were −7.93, −3.29, −0.80, −4.02, −2.05, −4.35, −4.77 and −2.82, respectively (all p ＜ 0.001). At the endpoint, the newly remitted subjects rate by HAMD score criteria were approximately 46%. Conclusion: Our preliminary findings have presented the effectiveness of aripiprazole augmentation for residual symptoms of partially remitted MDD patients in routine practice. This study assures subsequent well-controlled studies of the possibility of generalizing the above promising outcome in the future.

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Section: Discussionmentioning

confidence: 99%

Additional Reduction of Residual Symptoms with Aripiprazole Augmentation in the Patients with Partially Remitted Major Depressive Disorder

Shin

Pae

Kwak

et al. 2021

Clin Psychopharmacol Neurosci

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“…On the other hand, pain-relieving effects of aripiprazole were enhanced by co-administration of FAAH inhibitor, MAGL inhibitor, and AEA reuptake inhibitor [88]. Moreover, a case study on psychiatric patients showed that aripiprazole (2.5-15 mg/day) may exhibit antinociceptive action also in humans [89]. However, more research is needed in this area.…”

Section: Painmentioning

confidence: 99%

A Guide to Targeting the Endocannabinoid System in Drug Design

Stasiulewicz

Znajdek

Grudzień

et al. 2020

IJMS

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The endocannabinoid system (ECS) is one of the most crucial systems in the human organism, exhibiting multi-purpose regulatory character. It is engaged in a vast array of physiological processes, including nociception, mood regulation, cognitive functions, neurogenesis and neuroprotection, appetite, lipid metabolism, as well as cell growth and proliferation. Thus, ECS proteins, including cannabinoid receptors and their endogenous ligands’ synthesizing and degrading enzymes, are promising therapeutic targets. Their modulation has been employed in or extensively studied as a treatment of multiple diseases. However, due to a complex nature of ECS and its crosstalk with other biological systems, the development of novel drugs turned out to be a challenging task. In this review, we summarize potential therapeutic applications for ECS-targeting drugs, especially focusing on promising synthetic compounds and preclinical studies. We put emphasis on modulation of specific proteins of ECS in different pathophysiological areas. In addition, we stress possible difficulties and risks and highlight proposed solutions. By presenting this review, we point out information pivotal in the spotlight of ECS-targeting drug design, as well as provide an overview of the current state of knowledge on ECS-related pharmacodynamics and show possible directions for needed research.

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“…A study that documented the effect of blonanserin on treatment-resistant SSD also explained that the efficacy was due to its high affinity for D 2 receptors, which plays a prominent role in OCD (Nagoshi et al, 2016). Third, the analgesic effects of aripiprazole have been reported previously (Fei et al, 2012;Seidel et al, 2013). Aripiprazole was suggested to reduce somatic symptoms by increasing the pain threshold due to dopaminergic modulation in the descending nociceptive pathway mediated by its partial agonism at the D 2 receptor as well as by an increase in norepinephrine availability due to 5-HT 2A antagonism (Kasahara et al, 2011;Shin et al, 2021).…”

Section: Discussionmentioning

confidence: 88%

“…Aripiprazole, a dopamine, serotonin receptor partial agonist, is expected to have potential strengths in treating somatic symptoms in patients with depression, owing to its pharmacological properties. Aripiprazole has been reported to increase the pain threshold through direct D 2 dopaminergic modulation in the descending nociceptive pathway as well as by an indirect increase in norepinephrine availability due to 5-HT 2A antagonism (Fei et al, 2012; Seidel et al, 2013; Shin et al, 2021). In addition, the fact that aripiprazole is effective at treating obsessive-compulsive disorder (OCD), which shares common features with somatic symptoms, suggests that it may improve somatic symptoms as well (Abramowitz, 2005; Nagoshi et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of aripiprazole as adjunctive therapy in major depressive disorder with somatic symptoms: A randomized, double-blind, placebo-controlled trial with clinical and electroencephalography evidence

et al. 2022

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Background: Somatic symptoms, which are common in major depressive disorder (MDD), are associated with a worse prognosis and increased health costs. Aims: This randomized, double-blind, placebo-controlled study evaluated the efficacy of aripiprazole augmentation in MDD patients with somatic symptoms. Methods: In all, 41 MDD patients with somatic symptoms completed the study. Participants who had been on a stable dose of antidepressants for at least 1 month were randomly assigned to receive an 8-week adjunctive treatment with either aripiprazole or placebo. The initiation dose of aripiprazole was 2 mg/day, which was later adjusted to 1–10 mg/day. The primary endpoint was the change in the Symptom Checklist-90-Revised-Somatization (SCL-90-R-SOM) score. We collected quantitative electroencephalogram data and performed spectral analyses to obtain the absolute power of frequency bands. Results/outcomes: The aripiprazole group ( n = 20; 2.98 ± 1.75 mg/day) showed a significant improvement in SCL-90-R-SOM scores compared to the placebo group ( n = 21; F = 8.56, p = 0.006), without significant differences in changes in depression and anxiety symptoms. Compared to the control, the aripiprazole group showed a greater decrease in total alpha power ( F = 7.03, p = 0.01). Changes in frontal alpha power were positively correlated with changes in SCL-90-R-SOM scores in the aripiprazole group ( r = 0.53, p = 0.014). Conclusions/interpretation: Aripiprazole adjunctive to antidepressants in patients with MDD and somatic symptoms improved somatic symptom severity without significant safety concerns, and this improvement correlated with a decrease in total and frontal alpha power. Trial Registration: https://cris.nih.go.kr ; identifier: KCT0004607.

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Unexpected effect of aripiprazole on nociceptive pain

Cited by 12 publications

References 6 publications

Additional Reduction of Residual Symptoms with Aripiprazole Augmentation in the Patients with Partially Remitted Major Depressive Disorder

Additional Reduction of Residual Symptoms with Aripiprazole Augmentation in the Patients with Partially Remitted Major Depressive Disorder

A Guide to Targeting the Endocannabinoid System in Drug Design

Efficacy of aripiprazole as adjunctive therapy in major depressive disorder with somatic symptoms: A randomized, double-blind, placebo-controlled trial with clinical and electroencephalography evidence

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