Aripiprazole and bipolar disorder

Researchers from the University of Thessaloniki and the University of Barcelona reviewed 181 studies into the effectiveness of the antipsychotic drug aripiprazole in treating bipolar disorder. They found that although it had little effect in the depressive phase of the illness it was useful in preventing and treating mania. The most frequent side effect was akathisia (an unpleasant sensation of restlessness with an inability to sit still or remain motionless).

Fountoulakis, Konstantinos N. and Vieta, Eduard - Efficacy and safety of aripiprazole in the treatment of bipolar disorder: a systematic review Annals of General Psychiatry 2009, 8(16)

Aripiprazole and alcoholism

Dopamine is a neurotransmitter that sends messages in the brain and it is known that people with alcohol and substance abuse problems have abnormalities in the way they produce and process it. Aripiprazole is an atypical antipsychotic drug used in the treatment of schizophrenia which affects dopamine levels and a team of researchers in the U.S. conducted a trial to see whether it would be useful in treating alcoholism. The study of 295 people divided them into one group who received the aripiprazole and another who received a placebo. More people dropped out of the aripiprazole group than the placebo group and the aripiprazole group also suffered more side effects. The mean percentage of days abstinent was higher in the placebo group. The percentage of subjects without a heavy drinking day and the length of time to the first drinking day were about the same between the two groups.

Anton, Raymond F. ... [et al] - A randomized, multicenter, double-blind, placebo-controlled study of the efficacy and safety of aripiprazole for the treatment of alcohol dependence Journal of Clinical Psychopharmacology February 2008, 28(1), 5-12

Antipsychotics for depression in older people

Untreated or partially-treated depression in older people is associated with higher mortality due to illness and suicide. Failure of the depression to improve with antidepressant treatment is a common problem, since only 40-50% of patients respond to the first medication they are given. Recently the Sequenced Treatment Alternatives to Relieve Depression (STAR-D) study provided important information about treating patients whose depression did not improve with antidepressants but this did not cover patients over 60. Atypical antipsychotics, in combination with anti-depressants, have been increasingly studied for partially or non-responsive patients with depression and a New York trial of the drug aripiprazole, on older patients, has found that six weeks taking the drug, in conjunction with anti-depressants, led to a 50% remission rate of depression. However, the drug did have side effects including a dry mouth, which affected 25% of the participants, agitation/anxiety (20%) and drowsiness (15%). A quarter of the participants dropped out of the trial before it finished.

Rutherford, Bret ... [et al] - An open trial of aripiprazole augmentation for SSRI non-remitters with late-life depression International Journal of Geriatric Psychiatry October 2007 22(10), 986-991