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Adjunctive aripiprazole in treatment-resistant bipolar depression
Terence A Ketter1, Po W Wang, Rebecca A Chandler
1Stanford University School of Medicine, Stanford, CA, USA. tketter@stanford.edu
Summary
Aripiprazole showed effectiveness and good tolerability for treatment-resistant bipolar depression. Further controlled trials are recommended to confirm these findings in patients with difficult-to-treat bipolar depression.
Area of Science:
- Psychiatry
- Pharmacology
- Clinical Medicine
Background:
- Treatment-resistant depression (TRD) in bipolar disorder (BD) presents limited therapeutic options.
- Bipolar depression management remains a significant clinical challenge.
Purpose of the Study:
- To evaluate the efficacy and tolerability of adjunctive aripiprazole in patients with treatment-resistant bipolar depression.
- To assess preliminary outcomes of aripiprazole treatment in a naturalistic setting.
Main Methods:
- An open-label adjunctive trial of aripiprazole was conducted in outpatients with TRD.
- Patients were assessed using the Systematic Treatment Enhancement Program for BD (STEP-BD) Affective Disorders Evaluation and Clinical Monitoring Form.
- Demographics, medication history, and treatment outcomes were recorded.
Main Results:
- Aripiprazole was administered to 30 patients with BD-TRD, with a mean final dose of 15.3 mg/day.
- Significant improvement was observed in Clinical Global Impression-Severity (CGI-S) scores (p < 0.01).
- 27% of patients responded and 13% remitted based on CGI-S criteria; mood and suicidal ideation also improved. Aripiprazole was generally well tolerated.
Conclusions:
- Adjunctive aripiprazole demonstrated potential efficacy and tolerability in treating patients with treatment-resistant bipolar depression.
- These findings suggest aripiprazole as a viable option for this patient population.
- Controlled trials are necessary to validate these preliminary observations.
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