Comparing the efficacy of aripiprazole as an add-on to valproate with other second-generation antipsychotics in acute mania symptoms in manic patients in Iran

Abstract

Background Given the great importance of treating patients with bipolar disorder, the aim of this study was to compare the efficacy of aripiprazole with other second-generation antipsychotics in relieving acute symptoms of mania. Materials and methods In this study, 50 patients with bipolar I disorder, manic episode, were divided into two groups receiving aripiprazole (n = 25) and other second-generation antipsychotics (risperidone, olanzapine, and quetiapine) (n = 25) for 6 weeks. The disease severity was evaluated and compared according to YMRS and CGI criteria. Results The mean severity of mania according to YMRS and CGI, at week 0 in comparison with weeks 2, 4 and 6 in both groups was significantly different (p < 0.0001) and the treatment with Aripiprazole at week 2 (p < 0.0001) and 4 (p = 0.0002) was significantly better than the other second-generation antipsychotics. The two groups also showed an overall improvement in CGI-based results at weeks 4 and 6 (p = 0.002). In addition, the efficacy index for aripiprazole at weeks 4 (p = 0.011) and 6 (p < 0.0001) as well as disease improvement in the second (p < 0.0001) and fourth (p = 0.026) weeks after treatment were better than the other second-generation antipsychotics. Conclusions Aripiprazole and other second-generation antipsychotics, 2 weeks after initiation of treatment, significantly reduced mania severity in patients with bipolar disorder, however, aripiprazole seems to be more efficient and faster for controlling mania in patients with bipolar disorder. KEY POINTS Aripiprazole and other second-generation antipsychotics, 2 weeks after initiation of treatment, significantly reduced mania severity in patients with bipolar disorder. Comparison between the two drugs, aripiprazole showed a more beneficial role in the second and fourth weeks than second-generation antipsychotics. Due to the fact that the possible mechanisms involved in the role of aripiprazole have not been considered compared to other antipsychotics in patients with bipolar disorder, there is a need for more extensive studies in this field.