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Aripiprazole versus other atypical antipsychotics for schizophrenia
Katja Komossa1, Christine Rummel-Kluge, Franziska Schmid
1Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München Klinikum rechts der Isar, Moehlstrasse 26, München, Germany, 81675.
The Cochrane Database of Systematic Reviews
|October 13, 2009
Summary
Aripiprazole may be less effective than olanzapine for schizophrenia but offers better tolerability. It shows similar efficacy to risperidone with fewer side effects like dystonia and metabolic changes.
Area of Science:
- Psychiatry
- Pharmacology
- Clinical Trials
Background:
- Second-generation antipsychotics are first-line treatments for schizophrenia.
- Debate exists regarding the differential effects of various second-generation antipsychotics.
- This review compares aripiprazole's efficacy and tolerability against other atypical antipsychotics.
Purpose of the Study:
- To evaluate the effects of aripiprazole compared with other atypical antipsychotics.
- Focus on people with schizophrenia and schizophrenia-like psychoses.
Main Methods:
- Searched the Cochrane Schizophrenia Group Trials Register (March 2007).
- Included randomized trials comparing oral aripiprazole with other oral second-generation antipsychotics.
- Extracted data independently using random-effects models for relative risks and weighted mean differences.
Main Results:
- Four trials (1404 participants) compared aripiprazole vs. olanzapine and aripiprazole vs. risperidone.
- Aripiprazole was less efficacious than olanzapine (PANSS total score) but had fewer side effects (metabolic, sedation).
- No efficacy difference vs. risperidone; aripiprazole had fewer dystonias, QTc abnormalities, and metabolic issues, but more tremor.
Conclusions:
- Aripiprazole may be less effective than olanzapine but is better tolerated regarding metabolic effects and sedation.
- No efficacy difference found compared to risperidone, with improved tolerability for dystonias, metabolic issues, and QTc prolongation.
- Limited randomized evidence exists comparing aripiprazole with other second-generation antipsychotics.
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