Summary

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• Aripiprazole (Abilify Maintena) is indicated for the treatment of schizophrenia and maintenance monotherapy treatment of bipolar I disorder in adults. It has demonstrated effectiveness in treating acute bipolar manic episodes in youth, showing better tolerability compared to risperidone and olanzapine, but with less efficacy at higher doses.
• The analysis derived from 23 systematic reviews/meta-analyses on aripiprazole's efficacy, safety, tolerability, and considerations across various populations including children/adolescents and adults with schizophrenia or bipolar disorder.
• In young people experiencing early psychosis, aripiprazole led to significant weight gain, which suggests the need for close monitoring of metabolic side effects within this population group.
• For adult patients suffering from schizophrenia or bipolar disorder, aripiprazole showed high effectiveness as both an antipsychotic addressing positive/negative symptoms of schizophrenia, as well as a mood stabilizer. However, impulsive/compulsive behaviors were noted side effects that require attention.
• Among second-generation antipsychotics (SGAs), it displayed the highest effectiveness for managing conditions like bipolar mania and Tourette's Disorder, while its long-term use via injectable form significantly lowered the risk of discontinuation due to adverse events, indicating a favorable safety profile, especially among those diagnosed with chronic disorders such as schizoaffective disease/schizophrenia.
• Specific side effects include dose-dependent weight gain/metabolic disturbances, although comparatively lesser than other drugs like olanzapine; also, unlike risperidone/paliperidone/olanzapine which increased prolactin levels leading potentially harmful implications, particularly among younger users - aripiprazole actually decreased these levels, thereby reducing associated risks considerably.
• Comparative studies suggest that personalized dosing strategies might offer more benefits without significantly increasing adverse effects, making it an important consideration. Moreover, consistent response/improvement rates coupled with lower all-cause discontinuation rates make it more acceptable than a placebo.
• Aripiprazole's transdiagnostic efficacy across various disorders, meeting criteria for treatment across multiple DSM-5 diagnostic groups with a specific dose-response relationship, makes it a valuable option in the long-term management of schizophrenia and bipolar disorders.