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Aripiprazole for schizophrenia.

H G El-Sayeh1, C Morganti

  • 1Harrogate District Hospital, Briary Wing, Lancaster Park Road, Harrogate, West Yorkshire, UK, HG2 7SX. hany.el-sayeh@chrd-pct.nhs.uk

The Cochrane Database of Systematic Reviews
|April 21, 2006
PubMed
Summary

Aripiprazole shows effectiveness in treating schizophrenia, reducing relapse rates and improving adherence compared to placebo. However, it offers limited advantages over other antipsychotics regarding overall efficacy and tolerability, though it may reduce specific side effects.

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Area of Science:

  • Psychiatry and Pharmacology
  • Clinical Trial Analysis
  • Schizophrenia Treatment Research

Background:

  • Typical antipsychotics for schizophrenia present challenges, including treatment resistance and adverse effects.
  • Aripiprazole, an atypical antipsychotic, is investigated for its efficacy and safety profile.

Purpose of the Study:

  • To evaluate the clinical effectiveness of aripiprazole in patients with schizophrenia and schizophrenia-like psychoses.
  • To compare aripiprazole against placebo, typical, and other atypical antipsychotic medications.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) identified through comprehensive database searches.
  • Data extraction and analysis focused on efficacy, tolerability, and adverse events, employing intention-to-treat principles.

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  • Included 15 RCTs with 7110 participants, with an updated search identifying 5 additional papers.

    • Main Results:

    • Aripiprazole significantly reduced relapse rates and improved treatment adherence compared to placebo.
    • Compared to typical antipsychotics, aripiprazole showed no significant differences in global state or quality of life, but reduced akathisia and antiparkinsonian medication needs.
    • Against other atypical antipsychotics (olanzapine, risperidone), aripiprazole demonstrated similar efficacy but potentially lower prolactin elevation and QTc interval prolongation.

    Conclusions:

    • Aripiprazole demonstrates efficacy in schizophrenia treatment, comparable to existing typical and atypical antipsychotics.
    • It may offer a reduced risk of akathisia versus typical agents and lower prolactin and QTc prolongation versus some atypical agents.
    • Further well-reported, pragmatic RCTs are needed to establish aripiprazole's definitive role in clinical practice.