Aripiprazole Lauroxil
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Aripiprazole As an Adjunct to Anti-Depressants for Major Depressive Disorder: Clinical Effectiveness, Cost-Effectiveness, and Guidelines
TITLE: Aripiprazole as an Adjunct to Anti-Depressants for Major Depressive Disorder: Clinical Effectiveness, Cost-Effectiveness, and Guidelines DATE: 04 May 2016 RESEARCH QUESTIONS 1. What is the clinical efficacy of aripiprazole as an adjunct to antidepressants for the treatment of patients with major depressive disorder who have had an inadequate response to prior antidepressant treatments? 2. What is the cost-effectiveness of aripiprazole as an adjunct to antidepressants for the treatment of patients with major depressive disorder who have had an inadequate response to prior antidepressant treatments? 3. What are the evidence-based guidelines for the use of aripiprazole for the treatment of patients with major depressive disorder who have had an inadequate response to prior antidepressant treatments? KEY FINDINGS Three systematic reviews with meta-analyses, two randomized controlled trials, and two evidence-based guidelines were identified regarding the use of aripiprazole as an adjunct to antidepressants for the treatment of patients with major depressive disorder who have had an inadequate response to prior antidepressant treatments. METHODS A limited literature search was conducted on key resources including PubMed, Ovid PsychINFO, Ovid Embase, The Cochrane Library, University of York Centre for Reviews and Dissemination (CRD) databases, Canadian and major international health technology agencies, as well as a focused Internet search. No methodological filters were used to limit retrieval by study type. Where possible, retrieval was limited to the human population. The search was also limited to English language documents published between January 1, 2014 and April 29, 2016. Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. -
Download Executive Summary
Comparative Effectiveness Review Number 43 Effective Health Care Program Off-Label Use of Atypical Antipsychotics: An Update Executive Summary Background Effective Health Care Program Antipsychotics medications are approved The Effective Health Care Program by the U.S. Food and Drug Administration was initiated in 2005 to provide valid (FDA) for treatment of schizophrenia and evidence about the comparative bipolar disorder. These medications are effectiveness of different medical commonly divided into two classes, interventions. The object is to help reflecting two waves of historical consumers, health care providers, and development: the conventional others in making informed choices antipsychotics and the atypical. The among treatment alternatives. Through conventional antipsychotics served as the its Comparative Effectiveness Reviews, first successful pharmacologic treatment the program supports systematic for primary psychotic disorders such as appraisals of existing scientific schizophrenia. Having been widely used evidence regarding treatments for for decades, the conventional high-priority health conditions. It also antipsychotics also produced various side promotes and generates new scientific effects requiring additional medications, evidence by identifying gaps in which spurred the development of the existing scientific evidence and atypical antipsychotics. supporting new research. The program Currently, nine atypical antipsychotic drugs puts special emphasis on translating have been approved by FDA: aripiprazole, findings into a variety of useful asenapine, clozapine, iloperidone, formats for different stakeholders, olanzapine, paliperidone, quetiapine, including consumers. risperidone, and ziprasidone. These drugs The full report and this summary are have been used off-label (i.e., for available at www.effectivehealthcare. indications not approved by FDA) for the ahrq.gov/reports/final.cfm. treatment of various psychiatric conditions. -
Psychedelics in Psychiatry: Neuroplastic, Immunomodulatory, and Neurotransmitter Mechanismss
Supplemental Material can be found at: /content/suppl/2020/12/18/73.1.202.DC1.html 1521-0081/73/1/202–277$35.00 https://doi.org/10.1124/pharmrev.120.000056 PHARMACOLOGICAL REVIEWS Pharmacol Rev 73:202–277, January 2021 Copyright © 2020 by The Author(s) This is an open access article distributed under the CC BY-NC Attribution 4.0 International license. ASSOCIATE EDITOR: MICHAEL NADER Psychedelics in Psychiatry: Neuroplastic, Immunomodulatory, and Neurotransmitter Mechanismss Antonio Inserra, Danilo De Gregorio, and Gabriella Gobbi Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, Quebec, Canada Abstract ...................................................................................205 Significance Statement. ..................................................................205 I. Introduction . ..............................................................................205 A. Review Outline ........................................................................205 B. Psychiatric Disorders and the Need for Novel Pharmacotherapies .......................206 C. Psychedelic Compounds as Novel Therapeutics in Psychiatry: Overview and Comparison with Current Available Treatments . .....................................206 D. Classical or Serotonergic Psychedelics versus Nonclassical Psychedelics: Definition ......208 Downloaded from E. Dissociative Anesthetics................................................................209 F. Empathogens-Entactogens . ............................................................209 -
Second-Generation Long-Acting Injectable Antipsychotics: a PRACTICAL GUIDE Understanding Each of These Medications’ Unique Properties Can Optimize Patient Care
Second-generation long-acting injectable antipsychotics: A PRACTICAL GUIDE Understanding each of these medications’ unique properties can optimize patient care Brittany L. Parmentier, PharmD, MPH, here are currently 7 FDA-approved second-generation long-acting BCPS, BCPP 1-7 Clinical Assistant Professor injectable antipsychotics (LAIAs). These LAIAs provide a Department of Pharmacy Practice Tunique dosage form that allows patients to receive an antipsy- The University of Texas at Tyler Fisch College of Pharmacy chotic without taking oral medications every day, or multiple times per Tyler, Texas day. This may be an appealing option for patients and clinicians, but Disclosure The author reports no financial relationships with any because there are several types of LAIAs available, it may be difficult to companies whose products are mentioned in this article, or with determine which LAIA characteristics are best for a given patient. manufacturers of competing products. Since the FDA approved the first second-generation LAIA, risperidone long-acting injectable (LAI),1 in 2003, 6 additional second-generation LAIAs have been approved: • aripiprazole LAI • aripiprazole lauroxil LAI • olanzapine pamoate LAI • paliperidone palmitate monthly injection • paliperidone palmitate 3-month LAI • risperidone LAI for subcutaneous (SQ) injection. When discussing medication options with patients, clinicians need to consider factors that are unique to each LAIA. In this article, I describe the similarities and differences among the second-generation LAIAs, and address common questions about these medications. A major potential benefit: Increased adherence One potential benefit of all LAIAs is increased medication adherence com- pared with oral antipsychotics. One meta-analysis of 21 randomized con- trolled trials (RCTs) that compared LAIAs with oral antipsychotics and Current Psychiatry GEORGE MATTEI/SCIENCE SOURCE GEORGE MATTEI/SCIENCE Vol. -
Efficacy and Tolerability of Aripiprazole Versus D2 Antagonists in the Early
www.nature.com/npjschz REVIEW ARTICLE OPEN Efficacy and tolerability of aripiprazole versus D2 antagonists in the early course of schizophrenia: a systematic review and meta-analysis David D. Kim1,2, Alasdair M. Barr1,2, Lulu Lian1, Jessica W. Y. Yuen1, Diane Fredrikson3, William G. Honer2,3, Allen E. Thornton2,4 and ✉ Ric M. Procyshyn 2,3 Early intervention is essential for favorable long-term outcomes in schizophrenia. However, there is limited guidance in the scientific literature on how best to choose between dopamine D2 receptor (D2R) partial agonists and D2R antagonists in early stages of schizophrenia. The aim of this meta-analysis was to directly compare D2R partial agonists with D2R antagonists for efficacy and tolerability, using randomized controlled trials (RCTs) that involved participants diagnosed with first-episode psychosis, schizophrenia, or related psychotic disorders with a duration of illness ≤5 years. Fourteen RCTs, involving 2494 patients, were included in the meta-analysis. Aripiprazole was the only identified D2R partial agonist, and was not significantly different from pooled D2R antagonists for overall symptom reduction or all-cause discontinuation. However, aripiprazole was more favorable than pooled D2R antagonists for depressive symptoms, prolactin levels, and triglyceride levels. Specifically, aripiprazole was more favorable than paliperidone for triglyceride levels and more favorable than risperidone and olanzapine, but less favorable than ziprasidone, for weight gain. In addition, aripiprazole was less favorable for akathisia compared with second-generation D2R 1234567890():,; antagonists, in particular olanzapine and quetiapine, and less favorable for discontinuation due to inefficacy than risperidone. Lastly, aripiprazole was more favorable than haloperidol for various efficacy and tolerability outcomes. -
Aristada Initio (Aripiprazole Lauroxil), in Combination with Oral Aripiprazole for the Initiation of Aristada When Used for the Treatment of Schizophrenia in Adults
Aristada Initio™ (aripiprazole lauroxil) – New drug approval • On July 2, 2018, Alkermes announced the FDA approval of Aristada Initio (aripiprazole lauroxil), in combination with oral aripiprazole for the initiation of Aristada when used for the treatment of schizophrenia in adults. — The approval of Aristada Initio provides physicians with an alternative regimen to initiate patients onto any dose of Aristada injection on day 1. — Previously, the first Aristada injection was recommended in conjunction with oral aripiprazole for 21 consecutive days. • Oral aripiprazole is generically available as tablets, disintegrating tablets, and solution. Aripiprazole is also available as Abilify Maintena®, a brand extended-release injectable suspension. — The oral formulations are approved for the treatment of schizophrenia and other indications as outlined in the individual drug labels. — Abilify Maintena is indicated for the treatment of schizophrenia in adults and as maintenance monotherapy treatment of bipolar I disorder in adults. • Aristada Initio leverages Alkermes’ proprietary NanoCrystal® technology, which provides an extended-release formulation using a smaller particle size compared to Aristada, thereby enabling faster dissolution and more rapid achievement of relevant drug levels. • The effectiveness of Aristada Initio, in combination with oral aripiprazole and for the initiation of Aristada injection, was established by adequate and well-controlled studies of oral aripiprazole and Aristada injection in adult patients with schizophrenia. -
CENTRAL NERVOUS SYSTEM DEPRESSANTS Opioid Pain Relievers Anxiolytics (Also Belong to Psychiatric Medication Category) • Codeine (In 222® Tablets, Tylenol® No
CENTRAL NERVOUS SYSTEM DEPRESSANTS Opioid Pain Relievers Anxiolytics (also belong to psychiatric medication category) • codeine (in 222® Tablets, Tylenol® No. 1/2/3/4, Fiorinal® C, Benzodiazepines Codeine Contin, etc.) • heroin • alprazolam (Xanax®) • hydrocodone (Hycodan®, etc.) • chlordiazepoxide (Librium®) • hydromorphone (Dilaudid®) • clonazepam (Rivotril®) • methadone • diazepam (Valium®) • morphine (MS Contin®, M-Eslon®, Kadian®, Statex®, etc.) • flurazepam (Dalmane®) • oxycodone (in Oxycocet®, Percocet®, Percodan®, OxyContin®, etc.) • lorazepam (Ativan®) • pentazocine (Talwin®) • nitrazepam (Mogadon®) • oxazepam ( Serax®) Alcohol • temazepam (Restoril®) Inhalants Barbiturates • gases (e.g. nitrous oxide, “laughing gas”, chloroform, halothane, • butalbital (in Fiorinal®) ether) • secobarbital (Seconal®) • volatile solvents (benzene, toluene, xylene, acetone, naptha and hexane) Buspirone (Buspar®) • nitrites (amyl nitrite, butyl nitrite and cyclohexyl nitrite – also known as “poppers”) Non-Benzodiazepine Hypnotics (also belong to psychiatric medication category) • chloral hydrate • zopiclone (Imovane®) Other • GHB (gamma-hydroxybutyrate) • Rohypnol (flunitrazepam) CENTRAL NERVOUS SYSTEM STIMULANTS Amphetamines Caffeine • dextroamphetamine (Dexadrine®) Methelynedioxyamphetamine (MDA) • methamphetamine (“Crystal meth”) (also has hallucinogenic actions) • methylphenidate (Biphentin®, Concerta®, Ritalin®) • mixed amphetamine salts (Adderall XR®) 3,4-Methelynedioxymethamphetamine (MDMA, Ecstasy) (also has hallucinogenic actions) Cocaine/Crack -
Aripiprazole Attenuates the Discriminative-Stimulus and Subject-Rated Effects of D-Amphetamine in Humans
Neuropsychopharmacology (2005) 30, 2103–2114 & 2005 Nature Publishing Group All rights reserved 0893-133X/05 $30.00 www.neuropsychopharmacology.org Aripiprazole Attenuates the Discriminative-Stimulus and Subject-Rated Effects of D-Amphetamine in Humans 1 1,2 1,2 3,4,5 1,3,6 Joshua A Lile , William W Stoops , Andrea R Vansickel , Paul EA Glaser , Lon R Hays ,1,2,3 and Craig R Rush* 1 2 Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY, USA; Department of Psychology, College of Arts 3 and Sciences, University of Kentucky, Lexington, KY, USA; Department of Psychiatry, College of Medicine, University of Kentucky, Lexington, KY, 4 5 USA; Department of Anatomy and Neurobiology, College of Medicine, University of Kentucky, Lexington, KY, USA; Department of Pediatrics, College of Medicine, University of Kentucky, Lexington, KY, USA; 6Department of Internal Medicine, College of Medicine, University of Kentucky, Lexington, KY, USA The results of animal research suggest that the use of partial agonists at dopamine (DA) D2 receptors may be an effective strategy for the treatment of stimulant dependence. Aripiprazole is an atypical antipsychotic that has partial agonist activity at D2 receptors. In this experiment, seven human participants with a history of nontherapeutic stimulant use learned to discriminate 15 mg oral D-amphetamine. After acquiring the discrimination (ie X80% correct responding on four consecutive sessions), the effects of a range of doses of D- amphetamine (0, 2.5, 5, 10, and 15 mg), alone and in combination with aripiprazole (0 and 20 mg), were assessed. D-Amphetamine alone functioned as a discriminative stimulus, produced prototypical subject-rated drug effects (eg increased ratings of Active, Alert, Energetic) and elevated cardiovascular indices. -
Guidance on the Treatment of Antipsychotic Induced Hyperprolactinaemia in Adults
Guidance on the Treatment of Antipsychotic Induced Hyperprolactinaemia in Adults Version 1 GUIDELINE NO RATIFYING COMMITTEE DRUGS AND THERAPEUTICS GROUP DATE RATIFIED April 2014 DATE AVAILABLE ON INTRANET NEXT REVIEW DATE April 2016 POLICY AUTHORS Nana Tomova, Clinical Pharmacist Dr Richard Whale, Consultant Psychiatrist In association with: Dr Gordon Caldwell, Consultant Physician, WSHT . If you require this document in an alternative format, ie easy read, large text, audio, Braille or a community language, please contact the Pharmacy Team on 01243 623349 (Text Relay calls welcome). Contents Section Title Page Number 1. Introduction 2 2. Causes of Hyperprolactinaemia 2 3. Antipsychotics Associated with 3 Hyperprolactinaemia 4. Effects of Hyperprolactinaemia 4 5. Long-term Complications of Hyperprolactinaemia 4 5.1 Sexual Development in Adolescents 4 5.2 Osteoporosis 4 5.3 Breast Cancer 5 6. Monitoring & Baseline Prolactin Levels 5 7. Management of Hyperprolactinaemia 6 8. Pharmacological Treatment of 7 Hyperprolactinaemia 8.1 Aripiprazole 7 8.2 Dopamine Agonists 8 8.3 Oestrogen and Testosterone 9 8.4 Herbal Remedies 9 9. References 10 1 1.0 Introduction Prolactin is a hormone which is secreted from the lactotroph cells in the anterior pituitary gland under the influence of dopamine, which exerts an inhibitory effect on prolactin secretion1. A reduction in dopaminergic input to the lactotroph cells results in a rapid increase in prolactin secretion. Such a reduction in dopamine can occur through the administration of antipsychotics which act on dopamine receptors (specifically D2) in the tuberoinfundibular pathway of the brain2. The administration of antipsychotic medication is responsible for the high prevalence of hyperprolactinaemia in people with severe mental illness1. -
Neuromodulators for Functional Gastrointestinal Disorders (Disorders of Gutlbrain Interaction): a Rome Foundation Working Team Report Douglas A
Gastroenterology 2018;154:1140–1171 SPECIAL REPORT Neuromodulators for Functional Gastrointestinal Disorders (Disorders of GutLBrain Interaction): A Rome Foundation Working Team Report Douglas A. Drossman,1,2 Jan Tack,3 Alexander C. Ford,4,5 Eva Szigethy,6 Hans Törnblom,7 and Lukas Van Oudenhove8 1Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina, Chapel Hill, North Carolina; 2Center for Education and Practice of Biopsychosocial Care and Drossman Gastroenterology, Chapel Hill, North Carolina; 3Translational Research Center for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium; 4Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, United Kingdom; 5Leeds Gastroenterology Institute, St James’s University Hospital, Leeds, United Kingdom; 6Departments of Psychiatry and Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; 7Departments of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; and 8Laboratory for BrainÀGut Axis Studies, Translational Research Center for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium BACKGROUND & AIMS: Central neuromodulators (antide- summary information and guidelines for the use of central pressants, antipsychotics, and other central nervous neuromodulators in the treatment of chronic gastrointestinal systemÀtargeted medications) are increasingly used for treat- symptoms and FGIDs. Further studies are needed to confirm ment -
Psychotropic Drug Indications
PSYCHOTROPIC DRUG INDICATIONS (Part 1 of 2) Bipolar Disorder Mixed Generic Brand Form Mania Depression Episodes Maintenance MDD TRD PMDD Schizophrenia Others4 ATYPICAL ANTIPSYCHOTICS aripiprazole — tabs, ODT, oral √ √ √ √1 √ √ soln Abilify tabs √ √ √ √1 √ √ Abilify ext-rel IM inj √ √ Maintena Abilify tabs with √ √ √ √1 √ Mycite sensor aripiprazole Aristada ext-rel IM inj √ lauroxil Aristada ext-rel IM inj √ Initio asenapine Saphris sublingual tabs √ √ √ √ brexpiprazole Rexulti tabs √1 √ cariprazine Vraylar caps √ √ √ √ lurasidone Latuda tabs √ √ olanzapine Zyprexa tabs √ √2 √ √ √2 √ IM inj √ Zyprexa ext-rel IM inj √ Relprevv Zyprexa ODT √ √2 √ √ √2 √ Zydis quetiapine Seroquel tabs √ √ √ √ Seroquel XR ext-rel tabs √ √ √ √ √1 √ risperidone Perseris ext-rel SC inj √ Risperdal tabs, oral soln √ √ √ √ Risperdal ext-rel IM inj √ √ Consta Risperdal ODT √ √ √ √ M-tabs ziprasidone Geodon caps √ √ √1 √ IM inj √ COMBINATION ATYPICAL & SELECTIVE SEROTONIN REUPTAKE INHIBITOR olanzapine + Symbyax caps √ √ fluoxetine MONOAMINE OXIDASE INHIBITORS (MAOIs) phenelzine Nardil tabs √ selegiline EMSAM transdermal √ system tranylcypromine Parnate tabs √ SEROTONIN AND NOREPINEPHRINE REUPTAKE INHIBITORS (SNRIs) desvenlafaxine Khedezla ext-rel tabs √ Pristiq ext-rel tabs √ duloxetine Cymbalta caps √ √ levomilnacipran Fetzima ext-rel caps √ venlafaxine — scored tabs √ Effexor XR ext-rel caps √ √ SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIs) citalopram Celexa scored tabs √ escitalopram Lexapro scored tabs, √ √ oral soln fluoxetine — tabs, oral soln √3 √ √3 √ Prozac -
Antipsychotics-2020.Pdf
© Mind 2020 Antipsychotics Explains what antipsychotics are used for, how the medication works, possible side effects and information about withdrawal. If you require this information in Word document format for compatibility with screen readers, please email: [email protected] Contents What are antipsychotics? ...................................................................................................................... 2 Could antipsychotics help me? .............................................................................................................. 5 How to take antipsychotics safely ......................................................................................................... 9 What dosage of antipsychotics should I be on? .................................................................................. 15 Antipsychotics during pregnancy and breastfeeding ........................................................................... 17 What side effects can antipsychotics cause? ....................................................................................... 20 What is a depot injection? ................................................................................................................... 30 How can I compare different antipsychotics? ..................................................................................... 31 Can I come off antipsychotics? ............................................................................................................ 41 Alternatives to antipsychotics