Use of the Third-Generation Atypical Antipsychotic Aripiprazole (Zylaxera®) for Treatment of Depressive States in Schizophrenia: Efficacy and Safety Study

Abstract

Background: Aripiprazole, among other atypical antipsychotics, is recommended as a drug for maintenance therapy in schizophrenia in cases in which the patient is identified as having depressive symptoms. At the same time, depression in schizophrenia is not listed as a separate indication for Aripiprazole, its antidepressant properties are considered only in the recommendations for the treatment of bipolar depression and augmentation of antidepressant therapy in recurrent depressive disorder. There are no works characterizing the efficacy of the drug in depression in patients with schizophrenia, as well as evaluating the spectrum of its antidepressant action in such conditions.Objective of the study: to examine the therapeutic efficacy and safety of Aripiprazole (Zylaxera®) in the augmentation therapy of moderate to severe depressive states in patients with schizophrenia.Patients and methods: the efficacy and safety of Aripiprazole (Zylaxera®) augmentation therapy with 5–20 mg daily dose for 6 weeks was studied in 72 patients aged 18 to 47 years (all women) with depressive states of at least 17 Hamilton Scale scores in remitted schizophrenia, postchizophrenic depression and schizotypal disorder (F20.01 + F32.1–2; F20.04; F21.3–4 + F32.1–2). The HDRS-21, CGI, and UKU scales were used for psychometric assessment.Results: the effectiveness of augmentation of antidepressant therapy with Zylaxera® was revealed in the majority of patients: the rate of responders as evaluated by the HDRS-21 scale (reduction of severity of depressive disorders by 50% or more) was 67.2% and 71.4% for the CGI scale. At the same time, it was established that the group of responders had a certain similarity in terms of psychopathological structure of depressive states.Conclusion: it has been established, that in patients suffering from schizophrenia Zylaxera® has a distinct efficacy in augmentation of antidepressant therapy and has a favorable tolerability profile. The maximum efficacy of the drug within the framework of such use is observed in depressive states with predominance of negative affectivity.