Efficacy and safety of aripiprazole in the treatment of bipolar disorder: a systematic review

Konstantinos N Fountoulakis,Eduard Vieta

doi:10.1186/1744-859x-8-16

Abstract

BackgroundThe current article is a systematic review concerning the efficacy and safety of aripiprazole in the treatment of bipolar disorder.MethodsA systematic Medline and repositories search concerning the usefulness of aripiprazole in bipolar disorder was performed, with the combination of the words 'aripiprazole' and 'bipolar'.ResultsThe search returned 184 articles and was last updated on 15 April 2009. An additional search included repositories of clinical trials and previous systematic reviews specifically in order to trace unpublished trials. There were seven placebo-controlled randomised controlled trials (RCTs), six with comparator studies and one with add-on studies. They assessed the usefulness of aripiprazole in acute mania, acute bipolar depression and during the maintenance phase in comparison to placebo, lithium or haloperidol.ConclusionAripiprazole appears effective for the treatment and prophylaxis against mania. The data on bipolar depression are so far negative, however there is a need for further study at lower dosages. The most frequent adverse effects are extrapyramidal signs and symptoms, especially akathisia, without any significant weight gain, hyperprolactinaemia or laboratory test changes.

Highlights

The current article is a systematic review concerning the efficacy and safety of aripiprazole in the treatment of bipolar disorder
The treatment of bipolar illness started with lithium and Frederik Lange in the late 19th century [1]; later John Cade in 1949 [2,3,4] and Mogens Schou with Poul Christian Baastrup in the 1970s established its effectiveness [5,6,7,8,9,10]
A systematic Medline and repositories search of clinical trials.gov, Cochran collaboration and industry web sites concerning the usefulness of aripiprazole in bipolar disorder was performed, with the combination of the words 'aripiprazole' and 'bipolar'

Summary

Introduction

The current article is a systematic review concerning the efficacy and safety of aripiprazole in the treatment of bipolar disorder. Anticonvulsants are considered to be useful in the treatment of bipolar illness. The use and usefulness of antidepressant agents in bipolar disorder (BD) is controversial. Guidelines suggest their cautious use and always in combination with an antimanic agent [12]. This is because antidepressants are believed to induce switching to mania or hypomania [13,14,15,16], mixed episodes [17] and rapid cycling, while research suggests that the use of antimanic agents might protect from such an effect at least partially [18]

Methods

Results

Conclusion