Once-Monthly Aripiprazole as Maintenance Treatment for Bipolar I Disorder

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Once-monthly injectable aripiprazole is a viable option for maintenance treatment of bipolar I, which is in alignment with what has been shown for oral aripiprazole.
Once-monthly injectable aripiprazole is a viable option for maintenance treatment of bipolar I, which is in alignment with what has been shown for oral aripiprazole.

The following article is part of conference coverage from US Psych Congress 2018 in Orlando, Florida. Psychiatry Advisor's staff will be reporting breaking news associated with research conducted by leading experts in psychiatry. Check back for the latest news from US Psych Congress 2018.

ORLANDO, FL — Treatment with 400 mg once-monthly injectable aripiprazole demonstrates efficacy in preventing recurrence of mood episodes in patients with bipolar I, according to study results presented at the US Psych Congress 2018, held October 25-28, 2018 in Orlando, Florida.

Almost 50% of patients living with bipolar I experience recurrent episodes of acute manic or depressive symptoms despite adequate treatment. Therefore, this study investigated the effect of treatment with once-monthly injectable aripiprazole vs placebo on recurrence of a mood episode in 400 patients age 18 to 65 randomly assigned to treatment in a 52-week double-blind placebo-controlled study. 

Researchers demonstrated remission or recovery — defined as manic and depression scale scores <12 at follow-up visit and a sustained scale score <12 for 8 consecutive weeks, respectively — was achieved in 68% of participants receiving once-monthly aripiprazole. Recurrence of a mood episode occurred in 26% of participants. Participants who experienced recurrence had more frequent lifetime depressive episodes compared with participants who experienced remission or recovery (11.7 vs 6.5).  Individuals who experienced recurrence also had a history of more frequent lifetime manic episodes, as well as more mood episodes over a 10-year period prior to the study onset compared with participants who experienced remission or recovery.

Researchers noted that other baseline characteristics in participants who experienced recurrence and participants who experienced remission or recovery were similar, and concluded that 400 mg once-monthly injectable aripiprazole “is a viable option for maintenance treatment of bipolar I…which is in alignment with what has been shown for oral aripiprazole.”

Reference

Madera J, Such P, Zhang P, Baker R. Characteristics of patients in recovery versus patients with recurrence in a randomized placebo-controlled study with aripiprazole once-monthly as maintenance treatment for bipolar I disorder. Presented at: US Psych Congress 2018; October 25-28, 2018; Orlando, Florida. Poster 310.

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