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- Title
Aripiprazole long-acting injection: promising but more evidence needed.
- Authors
Keks, Nicholas A.; Hope, Judy; Culhane, Christine
- Abstract
<bold>Objective: </bold>Aripiprazole long acting injection (ALAI) is now available, and this paper aims to assist clinicians in deciding when to use ALAI.<bold>Conclusion: </bold>Aripiprazole is a partial dopamine agonist with low sedation, relatively favourable metabolic profile and a tendency to lower, rather than raise, prolactin. Available for over a decade, aripiprazole has been increasingly recognised by many clinicians as a useful option in the treatment of psychoses. ALAI is a suspension of crystalline aripiprazole in water which takes 5-7 days to reach steady state after an initial intramuscular injection. Monthly injections achieve steady state in four months. Studies have demonstrated that ALAI is effective in aripiprazole-responsive patients. ALAI was generally well tolerated, but more prone to cause extrapyramidal side-effects than the oral form. ALAI has not been compared with other depots. Although the recommended starting dose is 400 mg, it is likely that there will be significant inter-individual dose variation. Dose optimisation in each patient will be necessary for best effectiveness and tolerability. ALAI is currently appropriate for aripiprazole-responsive patients who need a depot, but clinicians are likely to try ALAI in patients who have been on other depots, particularly in whom weight gain and hyperprolactinaemia have been problematic.
- Subjects
ARIPIPRAZOLE; DOPAMINE; PROLACTIN; PSYCHOSES; PSYCHIATRIC treatment; DRUG side effects; HYPERPROLACTINEMIA; DRUG therapy for schizophrenia; ANTIPSYCHOTIC agents; INTRAMUSCULAR injections; PITUITARY diseases; WEIGHT gain
- Publication
Australasian Psychiatry, 2016, Vol 24, Issue 4, p368
- ISSN
1039-8562
- Publication type
journal article
- DOI
10.1177/1039856216632399