Combination of aripiprazole with mood stabilizers for the treatment of bipolar disorder: from acute mania to long-term maintenance

  title={Combination of aripiprazole with mood stabilizers for the treatment of bipolar disorder: from acute mania to long-term maintenance},
  author={Andrea de Bartolomeis and Giulio Perugi},
  journal={Expert Opinion on Pharmacotherapy},
  pages={2027 - 2036}
Introduction: Bipolar disorder is characterized by a complex set of symptoms, including recurrent manic, depressive or mixed episodes. Acute and long-term treatment of patients with bipolar disorder is mandatory to prevent symptom relapse and episode recurrences. Outcomes with monotherapy are often unsatisfactory in clinical practice, hence combinations of mood stabilizers and antipsychotics are widely utilized in patients showing no or partial response to, as well as intolerance to… 

Aripiprazole in the Treatment of Refractory Mood Disorders: A Case Series

  • Ather Muneer
  • Psychology, Medicine
    Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology
  • 2014
A case series of three patients is presented who suffered from refractory mood disorders but responded to aripiprazole with complete remission of affective symptoms, showing the efficacy and safety of this medication in subjects of all ages.

Treatment of the depressive phase of bipolar affective disorder: a review.

  • Ather Muneer
  • Psychology, Medicine
    JPMA. The Journal of the Pakistan Medical Association
  • 2013
In order to achieve better outcome for the patients, it is mandatory that treating physicians have an up to date knowledge of recent advances in the management of this condition.

Efficacy and Safety of Olanzapine/Fluoxetine Combination vs Fluoxetine Monotherapy Following Successful Combination Therapy of Treatment-Resistant Major Depressive Disorder

This is the first controlled relapse-prevention study in subjects with TRD that supports continued use of a second-generation antipsychotic beyond stabilization and time-to-relapse was significantly longer in OFC- treated patients compared with fluoxetine-treated patients.

Prolonged mania in a case of bipolar affective disorder.

  • Ather Muneer
  • Psychology, Medicine
    JPMA. The Journal of the Pakistan Medical Association
  • 2014
In a case where manic symptoms are showing resistance, an evidence-based pharmacotherapuetic approach by the treating physician is essential and the provision of psychological and social support to the patient is vital in conjunction with biological measures for optimal management.

Switching antipsychotic medication to aripiprazole: position paper by a panel of Italian psychiatrists

The strategies for the switch to aripiprazole presented in this position paper consider various scenarios encountered in clinical practice, highlight the importance of tapering the prior antipsychotic based on its pharmacological characteristics and provide detailed guidance throughout the entire switching process.

Hiccups Associated with Aripiprazole in an Adolescent with Bipolar Disorder.

An adolescent with newly diagnosed bipolar disorder who displayed acute hiccup during aripiprazole therapy is presented.

Korean Medication Algorithm for Bipolar Disorder 2014: comparisons with other treatment guidelines

The treatment recommendations of the Korean Medication Algorithm Project for Bipolar Disorder 2014 are similar to those of other treatment guidelines and reflect current changes in prescription patterns for bipolar disorder based on accumulated research data.

Efficacy and safety of olanzapine/fluoxetine combination in the treatment of treatment-resistant depression: a meta-analysis of randomized controlled trials

OFC is more effective than olanzapine or fluoxetine monotherapy in the treatment of patients with TRD and more large-scale, well-designed RCTs are needed to confirm these findings.

Low-dose manic switch and high-dose antimanic effect and extrapyramidal symptoms by aripiprazole in a single bipolar patient.

  • Young-Min Park
  • Psychology, Medicine
    American journal of therapeutics
  • 2014
Clinicians should carefully and vigilantly monitor for both the induction of mania and extrapyramidal symptoms according to the aripiprazole dose.



A clinical review of aripiprazole in bipolar depression and maintenance therapy of bipolar disorder.

  • L. Yatham
  • Psychology, Medicine
    Journal of affective disorders
  • 2011

Aripiprazole in Acute Mania and Long-Term Treatment of Bipolar Disorder

The efficacy and favourable metabolic profile of aripiprazole make it a good option in the management of acute mania and maintenance treatment, especially in an outpatient setting, and it provides clinicians with a valuable additional therapeutic option for BD.

Monotherapy versus combined treatment with second-generation antipsychotics in bipolar disorder.

  • T. Ketter
  • Psychology, Medicine
    The Journal of clinical psychiatry
  • 2008
The American Psychiatric Association guidelines for treating bipolar disorder recommend combination therapies to treat patients experiencing severe acute manic or mixed episodes and breakthrough

Comparative efficacy of typical and atypical antipsychotics as add-on therapy to mood stabilizers in the treatment of acute mania.

Atypical antipsychotics are an excellent choice as add-on therapy to mood stabilizers for the treatment of patients with mania due to their superior effectiveness and side effect profile when compared with typical antipsychotic.

Adjunctive valproate in panic disorder patients with comorbid bipolar disorder or otherwise resistant to standard antidepressants: a 3-year “open” follow-up study

VPA seems to be an effective and a well-tolerated adjunctive treatment in PD patients who were resistant to antidepressant therapy or had BD in comorbidity, and the hypothesis of resistance to antidepressant treatment being related to mood instability is supported.

Relapse prevention in bipolar I disorder: 18-month comparison of olanzapine plus mood stabiliser v. mood stabiliser alone

Patients taking olanzapine added to lithium orValproate experienced sustained symptomatic remission, but not syndromic remission, for longer than those receiving lithium or valproate monotherapy.

Aripiprazole Monotherapy in Nonpsychotic Bipolar I Depression: Results of 2 Randomized, Placebo-Controlled Studies

Aripiprazole monotherapy-as dosed in this study design-was not significantly more effective than placebo in the treatment of bipolar depression at end point (Week 8), and despite early statistical separation on the Clinical Global Impressions Bipolar Version Severity of Illness-Depression score (key secondary end point), aripIPrazole was not superior to placebo at endpoint.

Maintenance treatment for patients with bipolar I disorder: results from a north american study of quetiapine in combination with lithium or divalproex (trial 127).

In patients stabilized on quetiapine plus lithium or divalproex, continued treatment was associated with a significant risk reduction in the time to recurrence of any mood event compared with placebo and lithium ordivalproEx.

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2009.

The Canadian Network for Mood and Anxiety Treatments (CANMAT) published guidelines for the management of bipolar disorder in 2005, with a 2007 update. This second update, in conjunction with the

Effect of Aripiprazole Augmentation of Serotonin Reuptake Inhibitors or Clomipramine in Treatment-Resistant Obsessive-Compulsive Disorder: A Double-Blind, Placebo-Controlled Study

Evidence is provided that aripiprazole augmentation of SRIs/clomipramine treatment is well tolerated and may be proposed as an effective therapeutic strategy to improve outcome in treatment-resistant OCD.