Aripiprazole once-monthly long-acting injectable for the treatment of schizophrenia

Expert Opin Pharmacother. 2016;17(3):395-407. doi: 10.1517/14656566.2015.1114100.

Abstract

Introduction: Patient non-adherence increases the risk for relapse and the long-term care of schizophrenia. Long-acting injectable (LAI) antipsychotics can decrease this risk by ensuring adherence. An extended formulation, aripiprazole 400 mg once-monthly (AOM 400) LAI (AOM LAI), received regulatory approval in the year 2013 for the treatment of schizophrenia. AOM LAI is the first dopamine D2 partial agonist available in a long-acting formulation for the treatment of schizophrenia.

Areas covered: This review covers data on the efficacy and tolerability/safety of AOM LAI. AOM LAI is a lyophilized powder of aripiprazole, with an elimination half-life of 29.9 - 46.5 days, allowing for a 4-week injection interval. Antipsychotic efficacy was documented in a 12-week double-blind trial (n = 340) and in two maintenance-of-effect trials: a 38-week trial (n = 662) and a 52-week trial (n = 403). The side effect profile is similar to that of oral aripiprazole. Adverse events (≥5% and at least twice that for placebo) were typically mild or moderate and did not lead to discontinuation: increased weight, akathisia, injection site pain and sedation. The 400 mg dose is tolerated by >90% of patients. Injection does not require additional training of health personnel or post-injection observation.

Expert opinion: AOM LAI is an efficacious and well-tolerated antipsychotic treatment for schizophrenia.

Keywords: LAI; aripiprazole; atypical antipsychotic; long-acting injectable; quality of life; schizophrenia.

Publication types

  • Review

MeSH terms

  • Antipsychotic Agents / pharmacokinetics
  • Antipsychotic Agents / therapeutic use*
  • Aripiprazole / pharmacokinetics
  • Aripiprazole / therapeutic use*
  • Delayed-Action Preparations
  • Drug Administration Schedule
  • Drug Partial Agonism
  • Humans
  • Injections, Intramuscular
  • Randomized Controlled Trials as Topic
  • Receptors, Dopamine D2 / agonists*
  • Schizophrenia / drug therapy*

Substances

  • Antipsychotic Agents
  • Delayed-Action Preparations
  • Receptors, Dopamine D2
  • Aripiprazole