Aripiprazole in the treatment of acute manic or mixed episodes in patients with bipolar I disorder:

• Dosing could be reduced to 15 mg/day for Tolerability

• Aripiprazole : no significant difference from placebo in change in mean body weight

• not associated with elevated prolactin or QTc prolongation

• cholesterol• triglycerides• low-density lipopro

tein (LDL)• LDL/HDL,• Chol/HDL

• fasting glucose,

• fasting insulin

• insulin resistance index

treatment of an acute manic episode for up to 12 weeks

Aripiprazole showed superior levels of response and tolerability to haloperi

dol

• Aripiprazole showed similar efficacy to olanzapine for long-term treatment of acutely psychotic and chronic, stable schizophrenia patients,

• lower liability for weight gain or increased lipid levels

Aripiprazole: initial clinical experience with 142 hospitalized psychiatric patients.

• daily dose, 16.1 +/- 6.2 mg• body weight: 0.20 +/- 0.09 mg/kg • aripiprazole is likely to be onsidered for obe

se patients• weight should be considered

short-term treatment of schizophrenia

1. aripiprazole 15-30 mg is as effective

2. haloperidol 10 mg/day 3. risperidone 6 mg/day

• quinolinone derivative• high affinity for D2 , D3 receptors• partial agonist action on 5-HT (1A) recep

tors • 5-HT (2A) receptors antagonist

Aripiprazole

• active metabolite: dehydro-aripiprazole, = parent compound dopamine D2 receptors

• peak plasma concentration=3 hours • Steady-state plasma concentrations are ac

hieved by 14 days • CYP3A4 and CYP2D6 transform it to dehydr

oaripiprazole • genetic polymorphism • The drug is effective as early as the first or

second week of treatment.

• No additional therapeutic benefit at the higher-than-recommended dosages

induce weight gain

• clozapine and olanzapine.• TCA, mirtazapine come next• majority of the mood stabilizers.• The old antipsychotics seem to involve l

ess gain of weight.• SSRI make lose weight in the first weeks,

but induce a moderate weight gain on the long term.