Aripiprazole Start Not Linked With Serious Treatment Failure

February 11, 2019

Starting aripiprazole after a previous antipsychotic medication did not seem to increase the risk of psychiatric hospitalization, self-harm, or suicide, compared with starting another antipsychotic drug, according to a study published online in JAMA Psychiatry.

“Some reports have raised concerns regarding a potential psychiatric worsening associated with first-time use of aripiprazole in patients already treated with other antipsychotic medications,” researchers wrote. “Whether aripiprazole use, particularly in the long term, increases the risk for serious psychiatric events is unclear.”

The population-based study included 1643 patients in the United Kingdom who, after starting an antipsychotic medication, either switched to or added aripiprazole. Researchers compared those patients with 1643 matched patients who switched to or added another antipsychotic drug. All patients were followed for up to 1 year.

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First-time aripiprazole use, researchers found, was not associated with an increased rate of psychiatric treatment failure (hazard ratio 0.87), psychiatric hospitalizations (hazard ratio 0.85), or self-harm or suicide (hazard ratio 0.96), compared with starting another antipsychotic drug.

“Switching to or adding aripiprazole may be associated with psychiatric worsening in some patients, but the findings suggest that these exacerbations do not lead to serious psychiatric treatment failure,” the study stated.

Researchers noted the findings  warrant replication in larger observational studies.

—Jolynn Tumolo

References

Montastruc F, Nie R, Loo S, et al. Association of aripiprazole with the risk for psychiatric hospitalization, self-harm, or suicide. JAMA Psychiatry. 2019 January 30;[Epub ahead of print].

BIDMC researchers ID and treat faulty brain circuitry that causes disabling symptoms of schizophrenia [press release]. Boston, Massachusetts: Beth Israel Deaconess Medical Center; January 30, 2019.