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Aripiprazole vs. Placebo or Haloperidol for Schizophrenia

 

Am Fam Physician. 2016 Dec 1;94(11):877-878.

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ARIPIPRAZOLE (ABILIFY) VS. PLACEBO OR HALOPERIDOL FOR SCHIZOPHRENIA

BenefitsHarms

1 in 5 avoided relapse compared with placebo

None

1 in 4 avoided antiparkinson medications compared with haloperidol

ARIPIPRAZOLE (ABILIFY) VS. PLACEBO OR HALOPERIDOL FOR SCHIZOPHRENIA

BenefitsHarms

1 in 5 avoided relapse compared with placebo

None

1 in 4 avoided antiparkinson medications compared with haloperidol

Details for This Review

Study Population: Adults with schizophrenia or schizoaffective disorder

Efficacy End Points: Relapse, global state, mental state, leaving the study early, quality of life

Harm End Points: Akathisia, extrapyramidal symptoms, nausea, headache, dyspepsia

Narrative: Antipsychotic drugs are a staple of modern treatment for psychosis-related disorders. Adverse effects from agents such as haloperidol, and a lack of effect on some symptoms, precipitated the development of the ‘atypical’ antipsychotics that have fewer movement problems. Aripiprazole (Abilify) is a relatively recent addition, approved by the U.S. Food and Drug Administration (FDA) for a broad array of conditions including schizophrenia, mania, depression, autism, agitation, and tic disorders. This review focused on the effects of aripiprazole compared with placebo or other typical antipsychotics such as haloperidol in patients with schizophrenia.

Fifteen studies with 7,110 patients were included, nine of which compared aripiprazole with placebo and six that compared aripiprazole with haloperidol.1 In one study, aripiprazole resulted in less relapse compared with placebo (number needed to treat [NNT] = 5, 95% confidence interval [CI], 4 to 8). In eight of the studies, aripiprazole produced better compliance with study protocol (NNT = 26, 95% CI, 16 to 239). Compared with haloperidol,

Author disclosure: No relevant financial affiliations.

REFERENCES

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1. El-Sayeh HG, Morganti C. Aripiprazole for schizophrenia. Cochrane Database Syst Rev. 2006;(2):CD004578....

2. Khanna P, Suo T, Komossa K, et al. Aripiprazole versus other atypical antipsychotics for schizophrenia. Cochrane Database Syst Rev. 2014;(1):CD006569.

3. Sharma T, Guski LS, Freund N, Gøtzsche PC. Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports. BMJ. 2016;352:i65.

4. U.S. Department of Health and Human Services; U.S. Food and Drug Administration. Alert for healthcare professionals: aripiprazole (marketed as Abilify). http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm151088.htm. Accessed November 4, 2016.

5. U.S. Department of Health and Human Services; U.S. Food and Drug Administration. FDA drug safety communication: FDA warns about new impulse-control problems associated with mental health drug aripiprazole (Abilify, Abilify Mainena, Aristada). http://www.fda.gov/Drugs/DrugSafety/ucm498662.htm. Accessed November 4 2016.


 

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