Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-02T21:47:50.505Z Has data issue: false hasContentIssue false
  • English
  • Français

Clinical Experience with Aripiprazole Treatment in Ten Elderly Patients with Schizophrenia or Schizoaffective Disorder: Retrospective Case Studies

Published online by Cambridge University Press:  07 November 2014

Subramoniam Madhusoodanan ,
Ronald Brenner ,
Sanjay Gupta ,
Harsha Reddy  and
Olivera Bogunovic
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Clinical trials of aripiprazole, a recentl Food and Drug Administration-approved atypical antipsychotic, included elderly patients, but more data are needed on the effects of aripiprazole in this population, especially those with comorbid medical illnesses.

Objective: To assess the response and safety of aripiprazole treatment in elderly patients with phrenia or schizoaffective disorder.

Method: Data was obtained by retrospective review of medical records. Aripiprazole was used to treat 10 elderly hospitalized patients between 62 and 85 years of age who manifested signs of psychosis related to schizophrenia or schizoaffective disorder. All patients had been treated previously with atypical and classic antipsychotics. Response was assessed by clinical observation of patients' behavior and Clinical Global Impression Scale assigned retrospectively.

Results: Seven patients responded to treatment, two did not respond, and one had a partial response. The mean Clinical Global Impression Scale scores improved from 6 (severely ill) at baseline to 2.3 (much improved) at discharge. Treatment was discontinued in the two patients who did not respond. Of the seven patients who responded, four presented with positive symptoms and showed significant improvement while three presented with positive and negative symptoms and both symptoms improved significantly. Four patients had preexisting extrapyramidal symptoms (EPS) and these symptoms decreased in three patients. In addition, two patients were able to discontinue antiparkinson medications. One patient who had severe tardive dyskinesia showed significant improvement in the dyskinetic symptoms. Four patients showed postural hypotension (without clinical symptoms) which resolved over time without treatment. Six patients showed a mean weight loss of 5.2 lbs. No adverse consequences occurred when divalproex sodium, carbamazepine, clonazepam or citalopram were given concurrently.

Conclusion: The reduction of both positive and negative symptoms of schizophrenia and the lack of significant EPS, tardive dyskinesia, sedation, weight gain, anticholinergic effects, and QTc prolongation gives preliminary indication that aripiprazole may be a safe and effective medication for elderly patients with schizophrenia or schizoaffective disorder.

Type
Original Research
Information
CNS Spectrums , Volume 9 , Issue 11 , November 2004 , pp. 862 - 867
Copyright
Copyright © Cambridge University Press 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Ability [package insert]. Otsuka America Pharmaceutical, Inc., Rockville, MD and Bristol-Myers Squibb Co., Princeton, NJ: November, 2002.Google Scholar
2. Inoue, A, Miki, S, Sefo, K, et al. Aripiprazole, a novel antipsychotic drug, inhibits quinpirole-evoked GTPase activity but does not up-regulate dopamine D2 receptor following repeated treatment in the rat striatum. Eur J Pharmacol. 1997:321:105–111.CrossRefGoogle Scholar
3. National Institutes of Mental Health. Clinical global impressions. In: Guy, E, ed. ECDEU Assessment Manual for Psychophcamacdogy. rev. Rockville, MD: National Institutes of Mental Health; 1976:218–220. DHEW Pub. No. (ADM) 76.Google Scholar
4. Koro, CE, Fedder, DO, L'ltalien, GJ, et al. Assessment of independent effect of olanzapine and risperidone on risk of diabetes among patients with schizophrenia: population based nested case-control study. BMJ. 2002;325:243.CrossRefGoogle ScholarPubMed
5. Caballero, E. Obesity, diabetes, and the metabolic syndrome: new challenges in antipsychotic drug therapy. CNS Spectr. 2003;8(suppl 2):19–22.CrossRefGoogle ScholarPubMed
6. American Diabetes Association; American Psychiatric Association; American Association of Clinical Endocrinologists; North American Association for the Study of Obesity. Consensus development conference on antipsychotic drugs and obesity and diabetes. J Clin Psychiatry. 2004;65:267–272.CrossRefGoogle Scholar
7. Kane, JMLarson, WH, Saha, AR, et al. Efficacy and safety of aripiprazole and haloperidol versus placebo in patients with schizophrenia and schizoaffective disorder. J Clin Psychiatry. 2002;63:763–771.CrossRefGoogle ScholarPubMed
8. Saha, AR, McQuade, R, Carson, WH, Ali, MW, Dunbar, GC, Ingenito, G. Efficacy and safety of aripiprazole and risperidone vs. placebo in patients with schizophrenia and schizoaffective disorder. Biol Psychiatry. 2001;2(suppl 1):305S.Google Scholar
9. Cornblatt, B, Kern, RS, Carson, WH, Ali, MW, Luo, X, Green, M. Neurocognitive effects of Aripiprazole vs. olanzapine in Stable psychosis. Int J Neuropsychopharnacol. 2002;5(suppl 1):S185.Google Scholar
10. Marder, SR, McQuade, RD, Stock, E, et al. Aripiprazole in the treatment of schizophrenia: Safety and tolerability in short-term, placebo-controlled trials. Schizophr Res. 2003;61:123–136.CrossRefGoogle ScholarPubMed
11. Potkin, SG, Saha, A, Kujawa, MJ, et al. Aripiprazole, an antipsychotic with a novel mechanism of action, and risperidone vs placebo in patients with schizophrenia and schizoaffective disorder. Arch Gen Psychiatry. 2003;60:681–690.CrossRefGoogle ScholarPubMed
12. Keck, PE, Marcus, R, Tourkodemitris, S, et al. A placebo controlled, double blind study of the efficacy and safety of aripiprazole in patients with acute bipolar mania. Am J Psychiatry. 2003;160:9:1651–1658.CrossRefGoogle ScholarPubMed
13. Pigott, TA, Carson, WH, Saha, AR, Torbeyrs, AF, Stock, EG, Ingenito, GG. Aripiprazole for the prevention of relapse in stabilized patients with chronic schizophreina: a placebo controlled 26 week study. J Clin Psychiatry. 2003:64:1048–1056.CrossRefGoogle Scholar
14. Kujawa, M, Saha, AR, Ingenito, GG, et al. Aripiprazole for long term maintenance treatment of schizophrenia. Int J Neuropsychopharmacol. 2002;5(suppl 1):S186.Google Scholar