Effectiveness of Switching to Aripiprazole From Atypical Antipsychotics in Patients With Schizophrenia

Abstract

To examine changes in cognitive function and clinical features after a switch from atypical antipsychotics to aripiprazole in patients with schizophrenia. Sixty-one patients with schizophrenia treated with atypical antipsychotics participated in this open-label, 26-week study. Antipsychotics were switched to aripiprazole, and neurocognitive functions were measured at 12 and 26 weeks using the computerized battery. The secondary outcome measures were the Positive and Negative Syndrome Scale, the Social and Occupational Functioning Assessment Scale, the Calgary Depression Scale for Schizophrenia, the Subjective Well-being Under Neuroleptics Scale, and the Drug Attitude Inventory (DAI). The safety measures included metabolic parameters, the Simpson-Angus Rating Scale, the Barnes Akathisia Scale, and the Abnormal Involuntary Movement Scale. Significant improvements in cognitive function were observed in the Verbal Learning Test, the Wisconsin Card Sorting Test, and the Trail Making Test part A after a switch to aripiprazole. Scores on the Positive and Negative Syndrome Scale, the Social and Occupational Functioning Assessment Scale, the DAI, the Simpson-Angus Rating Scale, and the Abnormal Involuntary Movement Scale were significantly improved. The metabolic parameters, including serum cholesterol levels, were also improved. The changes in cognitive measures were not correlated with the changes in positive symptoms or movements scales. The improvement of the scores on the DAI and the delayed recall of the Verbal Learning Test were significantly greater in the patients treated with antipsychotics for less than 1 year than in those treated for more than 1 year, in whom the improvement in metabolic parameters was significantly greater. Patients with schizophrenia who switched from their previous antipsychotics to aripiprazole demonstrated improvements in cognitive function, psychotic symptoms, social function, attitude toward medication, and metabolic abnormalities.