Aripiprazole in the Treatment of Schizophrenia

Giovan B. Cassano; Andrea Fagiolini; Lorenzo Lattanzi; Palmiero Monteleone; Cinzia Niolu; Emilio Sacchetti; Alberto Siracusano; Antonio Vita


Clin Drug Invest. 2007;27(1):1-13. 

In This Article


Our recommendations for dosage and administration of aripiprazole in patients experiencing schizophrenia are in agreement with the manufacturer's prescribing information. However, the optimal dose has to be evaluated individually for each case, depending on the characteristics of the patient. Use of aripiprazole in maintenance therapy usually requires a switch from a previous antipsychotic. In our experience, this works well, provided the change is made gradually by slowly decreasing the previous antipsychotic while increasing aripiprazole. If agitation is present in the acute episode, use of sedative drugs in combination with aripiprazole is highly recommended because aripiprazole does not have sedative effects at therapeutic doses.

Ultimately, the utility of an antipsychotic agent is determined by how the agent performs in everyday clinical practice, and how a patient feels and functions during treatment with that agent. Risk-benefit assessment is important when deciding on an anti-psychotic agent for the treatment of schizophrenia. There are many conventional and atypical anti-psychotic drugs currently available for the treatment of schizophrenia, and choosing the appropriate antipsychotic for the acute episode and long-term maintenance treatment can be a matter of trial and error until an acceptable balance is achieved between maximisation of efficacy and minimisation of adverse effects. Based on clinical data and our own clinical experience, aripiprazole is generally a well accepted, tolerated and safe first-line antipsychotic agent that is broadly effective against the positive and negative symptoms of schizophrenia.

Aripiprazole also represents a particularly useful alternative in patients in whom issues such as weight gain and hyperprolactinaemia and/or metabolic factors are currently or potentially problematic. In our experience, the majority of patients who have made the switch to aripiprazole have considered the effort to be worthwhile. The most frequent adverse events reported by patients treated with aripiprazole are generally transient and easily manageable. It must, however, be stated that aripiprazole is a relatively newly introduced antipsychotic agent, and further clinical experience and research data could help to fully understand its risk-benefit profile in the long-term management of schizophrenia.


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