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Published online: 27 June 2014
© Springer International Publishing Switzerland 2014
Abstract Aripiprazole (ABILIFY®) is an atypical antipsychotic drug that is proposed to act via partial agonism of dopamine D^sub 2^ receptors. Trials with oral aripiprazole have shown that, compared with some other atypical antipsychotics, aripiprazole is associated with fewer metabolic disturbances and has a favourable cardiovascular tolerability profile. Recently, an intramuscular long-acting injectable (LAI) depot formulation of aripiprazole (ABILIFY MAINTENA®) (aripiprazole LAI) has been approved for use as a treatment for schizophrenia in adults. The efficacy of aripiprazole LAI as a maintenance treatment for schizophrenia has been demonstrated in randomized clinical trials. In the trials, aripiprazole LAI was more effective than placebo, and noninferior to oral aripiprazole, in delaying relapse and in reducing relapse rates in schizophrenia. Aripiprazole LAI was generally well tolerated, with a tolerability profile consistent with that of oral aripiprazole. Thus, aripiprazole LAI is a valuable new treatment option for adult patients with schizophrenia. It may be of particular use for patients stable on oral aripiprazole who would prefer, or are likely to benefit from, a long-acting formulation.
1 Introduction
Schizophrenia is a chronic psychiatric disorder involving a range of emotional and cognitive dysfunctions [1, 2]. The condition is characterized by both positive symptoms (e.g. delusions, hallucinations, disorganized speech and behaviour), representing an excess or distortion of normal functions, and negative symptoms (e.g. diminished emotional expression, alogia and avolition), representing a diminution of normal functions [1]. Besides these psychotic symptoms, schizophrenia is also frequently associated with a decline in general functioning [1, 2]. Due to the chronic nature of the disorder, its ability to cause a broad range of functional impairments affecting many aspects of life, and its prevalence (with a worldwide median lifetime prevalence of approximately 0.4 % [3]), schizophrenia is associated with substantial socioeconomic costs [4].
Schizophrenia treatment is typically centred around management with antipsychotic drugs [4, 5]. Although the precise mechanisms of action remain unknown, antipsy- chotics generally act by blocking dopamine D^sub 2^ receptors [6]. Treatment of schizophrenia with antipsychotics falls into two general categories: (i) acute treatment to control (primarily) positive symptoms and (ii) maintenance treat- ment, aimed at decreasing the frequency and severity of acute exacerbations or relapses [5, 7]. First-generation (or typical) antipsychotics...