Abstract
Data from the first 13 schizophrenic (or schizoaffective) patients in this 12-week study were presented at the 2006 College Meeting; since then 15 more patients have been added. Aripiprazole 10 mg was added to current treatment for 1 week, and increased to 15 mg for the remaining 11 weeks. Further increase to 30 mg was permitted. Two rates of tapering (reductions of 5 mg or 2.5 mg olanzapine weekly) off the previous antipsychotic were compared. Equivalent doses of olanzapine, risperidone, quetiapine and amisulpride were 5, 2, 100 and 400 mg. Raters were blind to tapering rate.
Weight gain, sedation, diabetes, raised prolactin, memory problems, lethargy and anxiety were reasons for switching. Eight patients withdrew (reasons were insomnia, skin rash, hallucinations, inefficacy, left the country and non-compliance), so their last observations were carried forward. For the 28 patients the PANSS (Total, General, Negative and Positive) at 12 weeks compared with baseline were: 68.04 v 52.06∗∗∗, 34.93 v 26.46∗∗∗, 19.86 v 16.11∗∗, 13.25 v 10.29∗∗. Clinical Global Severity decreased from 3.5–2.75∗∗. Most of the benefits occurred within the first 4 weeks, and there were no difference between tapering rates. Body Mass Index decreased from 32.12–31.7∗. Impairment on Family Responsibilities on the Sheehan Disability Scale was significantly reduced∗. Fasting glucose decreased from 7.83 to 5.32∗, and fasting cholesterol from 4.91 to 4.68. Improvements were found in maze learning∗, ignoring irrelevant stimuli∗, and memory recall∗.
∗∗∗p <0.001, ∗∗p <0.001, ∗p <0.001
Caveats in interpreting these results are:
Participants were highly selected from those with adverse effects such as sedation, and weight gain. Therefore the findings cannot be generalized to all patients.
Raters were blind to tapering rates, but not to changing from other second-generation antipsychotics to aripiprazole.
