Aripiprazole: 6-month outcomes in a retrospective naturalistic study

Aim. The efficacy of aripiprazole has been demonstrated in randomised controlled trials, but due to inclusion and exclusion criteria, these may not be representative of clinical practice. The aim of this naturalistic study was to investigate patients from an acute mental health trust who received aripiprazole, using treatment discontinuation as a primary outcome measure. Method. All patients with schizophrenia or schizoaffective disorder who had received aripiprazole were identified from pharmacy records, and data collected by retrospective case note review. Results. Seventy subjects were included in the study. A total of 28 (40%, n=70) patients remained on aripiprazole monotherapy at 6 months. The most common reason for discontinuation was lack of effect, seen in 29 patients; only 12 patients discontinued due to adverse effects. Thirty-five percent of the subjects had previously been treated with clozapine, although this did not appear to influence outcome. Conclusion. Despite limitations of the naturalistic methodology used in this study, it appears that aripiprazole is relatively well tolerated, and effective in clinical practice. The 40% continuation rate seen with aripiprazole is comparable to that seen with risperidone, quetiapine, and perphenazine in the CATIE study at 6 months.