Currently, the dose dependency and benefits of different administration strategies of aripiprazole remain uncertain.
#Symptoms of taking too high a dose of ambify series
Furthermore, a series of recent studies have shown that doses higher than 15 mg/day or rapid dose escalation of aripiprazole may be more effective for treating schizophrenia ( 8– 12). However, aripiprazole is sometimes administered at a higher dose or the dose is rapidly increased (rapid titration) in clinical practice. Premarket clinical studies showed that doses higher than 10 or 15 mg/day were not more effective than 10 or 15 mg/day ( 7). Dosage increases should generally not be made before 2 weeks ( 7). According to the drug label, when administered in the oral formulation for the treatment of schizophrenia, the recommended starting and target dose for aripiprazole is 10 or 15 mg/day, and the maximum dose is 30 mg/day ( 7). Aripiprazole is known as a “dopamine system stabilizer” with a mechanism of action that exerts partial agonism with high affinity at dopamine D 2 and serotonin-5-HT 1A receptors as well as antagonism at serotonin-5-HT 2A receptors ( 2) and shows evidence of good clinical efficacy with a favorable profile of safety and tolerability in patients with schizophrenia ( 3– 6).Īs a partial agonist antipsychotic, the clinical usage of aripiprazole is different from other existing antipsychotics. Sensitivity analyses produced similar results.Ĭonclusion: The high-dose treatment strategy of aripiprazole for patients with schizophrenia or schizoaffective disorder may bring more benefits without obvious side effects.Īripiprazole is a second-generation antipsychotic with a unique pharmacological profile distinct from other available antipsychotics ( 1). With exception of somnolence, we did not find significant differences in side effects or discontinuation due to adverse events. The high-dose group showed superior effects compared with the low-dose group in long-term studies (more than 8 weeks) (standardized mean differences = −13.81, 95% CI = −25.07, −2.55 P < 0.01 I 2 = 96%).
The high-dose group showed significantly greater reductions in Positive and Negative Syndrome Scale (PANSS) total scores (standardized mean differences = −8.31, 95% confidence interval = −16.48, −0.13 P < 0.01 I 2 = 96%) than the low-dose group. If the initial or target doses of aripiprazole in a study were all higher than 15 mg/day, the high- and low-dose groups were created based on the relative level of the dose. We defined two treatment groups that represent different treatment strategies: (1) the high-dose group (the high-dose strategy) rapidly increased to doses higher than 15 mg/day in 2 weeks or began with doses higher than 15 mg/day, otherwise the group was defined as (2) the low-dose group (the low-dose strategy). Results: In total, nine RCTs were selected for meta-analysis, which covered ~1,187 participants.
We retrieved study design, participant characteristics, comparison groups, and outcomes from each study. Methods: We searched MEDLINE, EMBASE, the Cochrane Central, Web of Science, China National Knowledge Infrastructure(CNKI), and Wanfang Data Knowledge Service Platform(Wanfang) for randomized controlled trials (RCTs) of aripiprazole, using the terms: (aripiprazole) AND (schizophr * OR schizoaff *) AND (“syndrome scale” OR PANSS) AND (clini * OR trial). Purpose: To compare the efficacy and tolerability of different administration strategies of aripiprazole.
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