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Who responds to aripiprazole in clinical practice? An observational study of combination versus monotherapy

¹ NHS Lanarkshire, Consultant Psychiatrist, The Airbles Road Centre, 49 Airbles Road, Motherwell, Scotland, UK ML1 2TP.
² NHS Greater Glasgow and Clyde, Specialist Registrar, Springpark Mental Health Resource Centre, 101 Denmark Street, Glasgow, Scotland G22 5EU.
³ NHS Lanarkshire, Staff Grade Psychiatrist, The Airbles Road Centre, 49 Airbles Road, Motherwell, Scotland ML1 2TP.
⁴ NHS Greater Glasgow and Clyde, Consultant Psychiatrist, Springpark Mental Health Resource Centre, 101 Denmark Street, Glasgow, Scotland G22 5EU.

^* To whom correspondence should be addressed.

	Abstract

We aimed to study aripiprazole, as monotherapy and combined with other antipsychotics, in routine clinical practice, to identify patients who had a favourable clinical response. We retrospectively identified all secondary care psychiatric patient records started on aripiprazole (n_85). We assigned Clinical Global Impression scores to measure effectiveness. We examined demographic and clinical correlates of patients who improved (CGI Improvement scores _5) versus those who did not improve (CGI _ 5). 56 patients (66%) received aripiprazole as monotherapy, 29 patients (34%) in combination with other antipsychotics. 52 patients (62%) received a CGI 1–4 (minimally to very much improved), 32 patients (38%) a CGI _ 5 (no change to very much worse). Patients who improved were less likely to have had previous or subsequent treatment with clozapine (p_0.04). Discontinuation was due to agitation (35%), inefficacy (21%), nausea (18%) and worsening psychosis (12%). Combination with other antipsychotics resulted in less discontinuation and a lower maximum dose of aripiprazole. Aripiprazole was combined with other regular additional antipsychotics in 1/3rd of patients. Combination and monotherapy were clinically effective in around 60% of patients. Favourable response was associated with lack of treatment resistance. Agitation was the commonest reason for discontinuation.

Key Words: aripiprazole, antipsychotics, combination treatment

First published on February 28, 2008, doi:10.1177/0269881107083483

Journal of Psychopharmacology 2008;22:778.

A more recent version of this article appeared on September 1, 2008


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