Abstract
Background: Aripiprazole is an atypical antipsychotic with a pharmacological and clinical profile distinct from other atypical antipsychotics. Scope: A European multidisciplinary advisory panel of university-based experts in bipolar disorders convened in April 2010 to review new clinical guidelines for the management of mania and the role of aripiprazole in its treatment. This report describes the consensus reached on how best to use aripiprazole in the treatment of mania. Findings: Current guidelines recommending aripiprazole for first-line treatment of mania have not generally translated to clinical practice. The panel agreed that clinicians may not feel sufficiently knowledgeable on how to use aripiprazole effectively in mania, and that the perception that aripiprazole is less sedating than other antipschotics may hamper its use. There was consensus about the importance of ensuring that clinicians understood the distinction between antimanic efficacy and sedation. Most acutely manic patients may require night-time sedation, but continuous daytime sedation is not necessarily indicated and may interfere with long-term compliance. If sedation is necessary, guidelines recommend the use of adjunctive benzodiazepines only for a short-time. Conclusions: Clinical practice guidelines widely recommend aripiprazole as a first-line treatment for mania. Although clinical trials may not represent all patient subpopulations, they show that aripiprazole is well tolerated and has a long-term stabilizing potential. The successful use of aripiprazole rests on using the appropriate initial dose, titrating and adjusting the dose as needed and using appropriate concomitant medication to minimize any short-term adverse events. Low incidence of sedation makes aripiprazole a reasonable long-term treatment choice. If short-term sedation is required an adjunctive sedative agent can be added and removed when no longer needed. Clinical considerations should influence treatment choice, and a better distinction between sedation and antimanic effects should be an educational target aimed to overcome potential barriers for using non-sedative antimanic agents such as aripiprazole.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2285-2299 |
| Number of pages | 15 |
| Journal | Current Medical Research and Opinion |
| Volume | 27 |
| Issue number | 12 |
| DOIs | |
| State | Published - Dec 2011 |
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Keywords
- Aripiprazole
- Atypical antipsychotic
- Bipolar disorder
- Clinical use
- Mania
- Review
- Sedation
ASJC Scopus subject areas
- Medicine(all)
Cite this
Aripiprazole in patients with bipolar mania and beyond : An update of practical guidance. / Goodwin, Guy M.; Abbar, Mocrane; Schlaepfer, Thomas E.; Grunze, Heinz; Licht, Rasmus W.; Bellivier, Frank; Fountoulakis, Konstantinos N.; Carlo Altamura, Alfredo; Pitchot, William; Gren, Hans; Holsboer-Trachsler, Edith; Vieta, Eduard.
In: Current Medical Research and Opinion, Vol. 27, No. 12, 12.2011, p. 2285-2299.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Aripiprazole in patients with bipolar mania and beyond
T2 - An update of practical guidance
AU - Goodwin, Guy M.
AU - Abbar, Mocrane
AU - Schlaepfer, Thomas E.
AU - Grunze, Heinz
AU - Licht, Rasmus W.
AU - Bellivier, Frank
AU - Fountoulakis, Konstantinos N.
AU - Carlo Altamura, Alfredo
AU - Pitchot, William
AU - Gren, Hans
AU - Holsboer-Trachsler, Edith
AU - Vieta, Eduard
PY - 2011/12
Y1 - 2011/12
N2 - Background: Aripiprazole is an atypical antipsychotic with a pharmacological and clinical profile distinct from other atypical antipsychotics. Scope: A European multidisciplinary advisory panel of university-based experts in bipolar disorders convened in April 2010 to review new clinical guidelines for the management of mania and the role of aripiprazole in its treatment. This report describes the consensus reached on how best to use aripiprazole in the treatment of mania. Findings: Current guidelines recommending aripiprazole for first-line treatment of mania have not generally translated to clinical practice. The panel agreed that clinicians may not feel sufficiently knowledgeable on how to use aripiprazole effectively in mania, and that the perception that aripiprazole is less sedating than other antipschotics may hamper its use. There was consensus about the importance of ensuring that clinicians understood the distinction between antimanic efficacy and sedation. Most acutely manic patients may require night-time sedation, but continuous daytime sedation is not necessarily indicated and may interfere with long-term compliance. If sedation is necessary, guidelines recommend the use of adjunctive benzodiazepines only for a short-time. Conclusions: Clinical practice guidelines widely recommend aripiprazole as a first-line treatment for mania. Although clinical trials may not represent all patient subpopulations, they show that aripiprazole is well tolerated and has a long-term stabilizing potential. The successful use of aripiprazole rests on using the appropriate initial dose, titrating and adjusting the dose as needed and using appropriate concomitant medication to minimize any short-term adverse events. Low incidence of sedation makes aripiprazole a reasonable long-term treatment choice. If short-term sedation is required an adjunctive sedative agent can be added and removed when no longer needed. Clinical considerations should influence treatment choice, and a better distinction between sedation and antimanic effects should be an educational target aimed to overcome potential barriers for using non-sedative antimanic agents such as aripiprazole.
AB - Background: Aripiprazole is an atypical antipsychotic with a pharmacological and clinical profile distinct from other atypical antipsychotics. Scope: A European multidisciplinary advisory panel of university-based experts in bipolar disorders convened in April 2010 to review new clinical guidelines for the management of mania and the role of aripiprazole in its treatment. This report describes the consensus reached on how best to use aripiprazole in the treatment of mania. Findings: Current guidelines recommending aripiprazole for first-line treatment of mania have not generally translated to clinical practice. The panel agreed that clinicians may not feel sufficiently knowledgeable on how to use aripiprazole effectively in mania, and that the perception that aripiprazole is less sedating than other antipschotics may hamper its use. There was consensus about the importance of ensuring that clinicians understood the distinction between antimanic efficacy and sedation. Most acutely manic patients may require night-time sedation, but continuous daytime sedation is not necessarily indicated and may interfere with long-term compliance. If sedation is necessary, guidelines recommend the use of adjunctive benzodiazepines only for a short-time. Conclusions: Clinical practice guidelines widely recommend aripiprazole as a first-line treatment for mania. Although clinical trials may not represent all patient subpopulations, they show that aripiprazole is well tolerated and has a long-term stabilizing potential. The successful use of aripiprazole rests on using the appropriate initial dose, titrating and adjusting the dose as needed and using appropriate concomitant medication to minimize any short-term adverse events. Low incidence of sedation makes aripiprazole a reasonable long-term treatment choice. If short-term sedation is required an adjunctive sedative agent can be added and removed when no longer needed. Clinical considerations should influence treatment choice, and a better distinction between sedation and antimanic effects should be an educational target aimed to overcome potential barriers for using non-sedative antimanic agents such as aripiprazole.
KW - Aripiprazole
KW - Atypical antipsychotic
KW - Bipolar disorder
KW - Clinical use
KW - Mania
KW - Review
KW - Sedation
UR - http://www.scopus.com/inward/record.url?scp=81855180721&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=81855180721&partnerID=8YFLogxK
U2 - 10.1185/03007995.2011.628380
DO - 10.1185/03007995.2011.628380
M3 - Article
VL - 27
SP - 2285
EP - 2299
JO - Current Medical Research and Opinion
JF - Current Medical Research and Opinion
SN - 0300-7995
IS - 12
ER -