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To whom, when and in what dosage? The role of aripiprazole in the treatment of schizophrenia and bipolar disorder

Anna Z. Antosik-Wójcińska

Affiliacja i adres do korespondencji
Psychiatr Psychol Klin 2018, 18 (2), p. 188–193
DOI: 10.15557/PiPK.2018.0022
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Streszczenie

Aripiprazole is an atypical neuroleptic of proven effectiveness for the treatment of schizophrenia and bipolar I disorder. Despite its many years’ availability on the market, it tends not to be as popular as it deserves among psychiatrists. Aripiprazole is often used as an adjunctive treatment, added in a small dose to another neuroleptic, not as the primary antipsychotic treatment or prevention of manic episodes. Hence, its full benefits and optimal clinical effect cannot be achieved. This is due to the lack of knowledge concerning the full medical potential associated with the pharmacological profile of this neuroleptic and lack of awareness regarding its efficiency. Aripiprazole is characterised by better tolerability than some other antipsychotics, e.g. in terms of inducing symptomatic hyperprolactinemia, QTc prolongation, impaired glucose tolerance or significant weight gain. It is also associated with a low risk of extrapyramidal symptoms. Its good safety profile facilitates its use in patients with somatic burden, older than 65 years old and obese patients. The article briefly presents the current state of knowledge concerning the effect of aripiprazole in bipolar affective disorder and schizophrenia, focusing on the practical aspects. The following questions have been addressed:

  • Who is most likely to benefit from aripiprazole treatment, and how to adjust the dosage to the patient’s symptom profile?
  • When to consider a change of therapy to aripiprazole?
  • When is it appropriate to use aripiprazole as monotherapy and when as an element of combination therapy?

Several case reports have been included in the study to best illustrate the drug’s therapeutic potential.

Słowa kluczowe
aripiprazole, bipolar disorder, schizophrenia, high doses, clinical cases