Immediate versus gradual suspension of previous treatments during switch to aripiprazole: results of a randomized, open label study

Eur Neuropsychopharmacol. 2009 Aug;19(8):562-70. doi: 10.1016/j.euroneuro.2009.04.002. Epub 2009 May 12.

Abstract

The aim of the present work was to investigate possible differences in terms of efficacy and tolerability between different switching options to aripiprazole. 77 subjects were randomly assigned to (1) administration of aripiprazole (10 mg) with simultaneous discontinuation of current antipsychotic; (2) administration of aripiprazole (10 mg) and tapering off current antipsychotic over 4 weeks with half dose after the first 2 weeks; (3) administration of aripiprazole (10 mg) and tapering off current antipsychotic over 6 weeks with half dose after the first 2 weeks. Efficacy assessments included CGI-S, CGI-I, BPRS and SANS. Safety assessments included SAS, BAS and AIMS. Severity of symptoms significantly decreased from baseline over the 12 weeks of treatment. Patients switched to aripiprazole with immediate discontinuation of the previous antipsychotic showed an increase of symptoms' severity at week 1. However, severity of side effects did not overall change significantly during the 12-weeks follow-up. Previous treatment's tapering off strategy for switching patients to aripiprazole could be preferable as compared to abrupt discontinuation, in order to prevent early worsening of symptoms and premature discontinuation of treatment, though this results has to be considered with caution given the limitations of the study.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antipsychotic Agents / administration & dosage*
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / therapeutic use*
  • Aripiprazole
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Dropouts
  • Piperazines / administration & dosage*
  • Piperazines / adverse effects
  • Piperazines / therapeutic use*
  • Psychiatric Status Rating Scales
  • Quinolones / administration & dosage*
  • Quinolones / adverse effects
  • Quinolones / therapeutic use*
  • Schizophrenia / drug therapy*
  • Schizophrenic Psychology
  • Young Adult

Substances

  • Antipsychotic Agents
  • Piperazines
  • Quinolones
  • Aripiprazole