Tolerability and safety of long-acting injectable aripiprazole

2016 ◽  
Vol 33 (S1) ◽  
pp. s260-s261
Author(s):  
A. Porras Segovia ◽  
P. Calvo Rivera ◽  
B. Girela Serrano ◽  
L. Gutierrez Rojas
Keyword(s):  
Patient Satisfaction ◽  
Side Effects ◽  
Current Treatment ◽  
Average Score ◽  
Satisfaction Scale ◽  
New Drug ◽  
Attitude Inventory ◽  
Competing Interest ◽  
New Treatment ◽  
Long Acting

IntroductionLong-acting injectable aripiprazole is the most recently introduced depot treatment in schizophrenia.ObjectivesThe objective of this study is to determine the tolerability and safety of this new treatment.AimsThe aim is to provide useful information regarding the use of this new drug.MethodsOur sample consists on 20 patients treated with a monthly dose of long-acting ariprazole. They were previously stabilized on oral aripiprazole before the first injection. The data on tolerability and safety were obtained by face-to-face interviews, using the Hogan Drug Attitude Inventory, the Patient Satisfaction with Medication Questionnaire and the UKU Side Effects Scale.ResultsOur sample consists of 20 patients, with a 50/50 gender distribution and a mean age of 39 years. The average score in the satisfaction scale Hogan was positive (an average of 7.25). In the Patient Satisfaction With Medication Questionnaire, 85% said they were satisfied with the new treatment, compared with 15% who showed some degree of dissatisfaction with the change. Overall, 90% of patients showed a preference for the current treatment compared to the previous. The patients showed good tolerance to medication, with a low score in the UKU scale (total score = 13.5). Side effects did not interfere with daily activity of the patient.ConclusionsLong acting injectable aripiprazole proved to be a safe treatment, with a good degree of acceptance among patients. These advantages makes of this new drug a useful addition to our kit tool.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Awkward movements: Extrapyramidal symptoms in a group of patients treated with aripiprazole long acting injectable

2016 ◽  
Vol 33 (S1) ◽  
pp. S552-S553
Author(s):  
C. Victor ◽  
S. Berta ◽  
T. Ivan ◽  
O. Silvia ◽  
C. Sandra ◽  
...  
Keyword(s):  
Side Effects ◽  
Oral Treatment ◽  
Care Center ◽  
Extrapyramidal Symptoms ◽  
Average Score ◽  
Health Care Center ◽  
Normal Limits ◽  
Competing Interest ◽  
Long Acting

IntroductionExtrapyramidal symptoms are well known as side effects in therapy with antipsychotics. Explore this side effects is mandatory because they normally are a cause of treatment discontinuation or assess a change in medication. Some studies notice how long acting injectable antipsychotic cause less extrapyramidal symptoms than oral treatment, others does not find differences.ObjectiveThe aim of this study is to analyze the extrapyramidal symptoms presented on a group of patients treated with aripiprazole long acting injectable (ALAI) follow-up in a mental health care center.MethodsDescriptive study of a group of patients treated with ALAI. To assess the possible extrapyramidal symptoms due to treatment we have used the Simpson-Angus Scale (SAS). The follow up was 3 months after initiation of treatment.ResultsSix patients were included in the study, 2 women (33.3%) and 4 men (66.7%). The mean age of the sample was 37 years old. The different diagnoses of the group were 4 patients with psychotic disorder (66.7%; 2 schizophrenia, 1 schizoaffective disorder and 1 delusional chronic disorder) and the other 2 had an affective disorder (33.3%; both bipolar disorder). The average score for the SAS was 1.2 meaning normal results and therefore no significant extrapyramidal symptoms.ConclusionsIn our sample the average of the results obtained by applying the SAS is considered within normal limits. In our case as to extrapyramidal effects ALAI treatment has been well tolerated. A larger sample would be needed to obtain more reliable results.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Reasons to choose a long acting antipsychotic and tolerability

2017 ◽  
Vol 41 (S1) ◽  
pp. s822-s822
Author(s):  
I. Martínez Molina ◽  
N. Gómez-Coronado Suárez de Venegas ◽  
P. Blanco Ramón
Keyword(s):  
Side Effects ◽  
Sexual Dysfunction ◽  
Negative Symptoms ◽  
Descriptive Analysis ◽  
Hypertensive Crisis ◽  
Antipsychotic Treatment ◽  
Competing Interest ◽  
One Year ◽  
Long Acting ◽  
Positive And Negative Symptoms

IntroductionAripiprazole depot is an atypical antipshycotic used to treat positive and negative symptoms of psychosis or acute mania.AimDescribe the reason why psychiatrists switch the current antipsychotic treatment on to aripiprazol depot, its tolerability and the reasons to stop aripiprazol depot treatment.MethodsDescriptive analysis based on a sample of 37 patients, aged 18–65 years, treated during one year with antipsychotics at two community mental health units.ResultsSwitching on to aripiprazole depot principal reasons: promote adherence (25%), persistence of symptoms (25%) and high levels of prolactin or sexual dysfunction (16.66%):– side effects of aripiprazole depot: insomnia (11.11%), inquietude (8.33%), sexual dysfunction (2.77%) and hypertensive crisis during administration (2.77%);– 83.33% of the patients are still taking it after one year. The most common reasons to stop or change it were the presence of secondaries (11.11%) and clinical exacerbation (5.55%).ConclusionsAripiprazole depot is well tolerated (even better than other antipsychotics). Common side effects are not severe and appear in a small percent of patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Impact of Providing Audiotapes of Primary Adjuvant Treatment Consultations to Women With Breast Cancer: A Multisite, Randomized, Controlled Trial

2003 ◽  
Vol 21 (22) ◽  
pp. 4138-4144 ◽  
Author(s):  
Thomas F. Hack ◽  
Tom Pickles ◽  
Barry D. Bultz ◽  
J. Dean Ruether ◽  
Lorna M. Weir ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Patient Satisfaction ◽  
Side Effects ◽  
Adjuvant Treatment ◽  
Mood State ◽  
Controlled Trial ◽  
Information Provision ◽  
Average Score

Purpose: Women with breast cancer were provided with an audiotape of their primary adjuvant treatment consultation, and the following patient outcomes were measured at 12 weeks postconsultation: perceived degree of information provision, audiotape satisfaction and use, communication satisfaction with oncologist, mood state, and cancer-specific quality of life. Patients and Methods: Participants included 628 women newly diagnosed with breast cancer and 40 oncologists from six cancer centers in Canada. The patients were block randomized to one of four consultation groups: standard care control, not audiotaped; audiotaped, no audiotape given; audiotaped, patient given audiotape; and audiotaped, patient offered choice of receiving audiotape or not. Results: Patients receiving the consultation audiotape had significantly better recall of having discussed side effects of treatment than patients who did not receive the audiotape. Audiotape benefit was not significantly related to patient satisfaction with communication, mood state, or quality of life at 12 weeks postconsultation, and was not significantly affected by choice of receiving the audiotape. Patients rated the audiotape intervention positively, with an average score of 83.9 of 100. Conclusion: Audiotape provision benefits patients by facilitating their perception of being informed about treatment side effects, but does not significantly influence patient satisfaction with communication, mood state, or quality of life.

Intramuscular maintenance treatment with ultra-high-dose long-acting injectable aripiprazole in an elderly patient suffering from chronic refractory schizophrenia: A case report

2016 ◽  
Vol 33 (S1) ◽  
pp. S573-S573 ◽  
Author(s):  
L. Bartova ◽  
M. Dold ◽  
N. Praschak-Rieder ◽  
A. Naderi-Heiden ◽  
S. Kasper
Keyword(s):  
Side Effects ◽  
Maintenance Treatment ◽  
Rating Scale ◽  
Antipsychotic Treatment ◽  
High Dose ◽  
Symptom Scale ◽  
Meaningful Improvement ◽  
Plasma Level Monitoring ◽  
Competing Interest ◽  
Long Acting

Long-acting injectable (LAI) aripiprazole is increasingly appreciated in the course of a maintenance treatment of schizophrenia due to efficacy in delaying – and decreasing relapse, and low rates of feared side effects. In line with the prescribing information, the maximal starting – as well as maintenance dose was restricted to 400 mg following a 26-day interval between the single doses.We present a 72-year-old female inpatient (66 kg) with an acute exacerbation of chronic refractory schizophrenia, exhibiting primarily positive symptoms including excessive persecutory delusions, self-care deficit, poor insight and insufficient adherence to continuous intake of oral medication. Since she developed a post-injection syndrome after an accidental intravascular administration of olanzapine LAI 405 mg, the antipsychotic treatment was switched to aripiprazole LAI 300 mg once monthly. Due to insufficient clinical response, aripiprazole LAI was gradually increased up to 1200 mg per month under continuous plasma level monitoring. Here, 2 single injections of aripiprazole LAI 300 mg were delivered into both gluteal muscles concurrently, every 14 days.Consequently, we observed a clinically meaningful improvement (a total-score reduction from 111 to 75 on the Positive and Negative Syndrome Scale), as well as no objectifiable side effects, assessed by “The Dosage Record Treatment Emergent Symptom Scale” and “The Barnes Akathisia Rating Scale”, despite multi-morbidity and rather advanced age of the patient.Our safe experience with applying the almost threefold higher monthly dose over 12 weeks may encourage researchers to further investigate the efficacy, tolerability as well as handling of highly dosed aripiprazole LAI in refractory schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Treatment attitude and hospitalization: Comparison of oral therapy and long-acting injectable (LAI) antipsychotics in patients with schizophrenia

2017 ◽  
Vol 41 (S1) ◽  
pp. S369-S370
Author(s):  
L. Montemagno ◽  
M. Ludovico ◽  
A. Distefano ◽  
M. Marta Valentina ◽  
B. Mariacatena ◽  
...  
Keyword(s):  
Oral Drug ◽  
Global Functioning ◽  
Attitude Inventory ◽  
Oral Group ◽  
Schizophrenic Patients ◽  
Olanzapine Pamoate ◽  
Competing Interest ◽  
Oral Antipsychotic ◽  
Long Acting ◽  
Drug Attitude Inventory

BackgroundAdherence to prescribed antipsychotic drugs is a crucial factor in predicting medium- to long-term clinical outcome in schizophrenia. A helpful approach to promote adherence in schizophrenia is the use of long-acting injectable (LAI) antipsychotics.ObjectTo evaluate:– the global functioning and the hospitalization rate occurred in the year before and in the year following the switch from a low-efficacy oral antipsychotic to either a LAI once-monthly therapy (palmitate paliperidone or olanzapine pamoate) or the corresponding oral compound (paliperidone\risperidone or olanzapine) in schizophrenic patients;– the treatment attitude and the insight in patients treated with second-generation antipsychotic (SGA)-LAIs and with the corresponding oral compounds.MethodSixty adult schizophrenic outpatients: thirty were switched to LAIs and thirty to the corresponding oral antipsychotic. We used the following scales: Drug Attitude Inventory (DAI), Schedule for the Assessment of Insight (SAI), Life Skill Profile (LSP).ResultsNumber of hospitalizations per year decreased in both groups (LAIs: from 1.3 ± 0.5 to 0.3 ± 0.5; oral: from 1.3 ± 0.5 to 0.6 ± 0.5). We found a direct association between the “hospitalization event” and the oral drug compared to the corresponding LAI formulation (P = 0.049; OR: 3.05; 95% IC: 1.01–9.26). Patient receiving LAIs achieved a more significant improvement at the LSP score compared to the oral group (P < 0.001 vs. P = 0.0034) and higher DAI (5.9 ± 4.3 vs. −1.1 ± 4.3) and SAI (8.7 ± 2.9 vs. 5.6 ± 2.1).ConclusionsOur data suggest that SGA-LAIs, improving the adherence to the treatment, may sensitively reduce costs in mental health services.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals MON-LB018 Paediatric Type 2 Diabetes in a Single Centre in East London in the Period 2009-2018

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Evelien F Gevers ◽  
Anna Giuffrida
Keyword(s):  
Type 2 Diabetes ◽  
Learning Difficulties ◽  
Current Treatment ◽  
Sleep Apnoea ◽  
Temporary Reduction ◽  
Prandial Insulin ◽  
Acting Insulin ◽  
New Treatment ◽  
Long Acting

Abstract Background: The incidence of Paediatric type 2 diabetes is increasing, especially in areas of deprivation. Aim: To describe the cohort of CYP with T2D in Royal London Hospital over the period 2009-2018. Methods: Retrospective analysis of patient cohort. Results: Number of new patients doubled from 2.6/year in 2009-2013 to 5.3/year in 2014-2018. Prevalence in our cohort is 7.5% (national average of 2.5%, NPDA 2017-2018). Fourty patients (25 female, 15 male) were diagnosed in 2009-2018, with a mean age at diagnosis of 13.9+/-1.7 yrs. Males had more frequently learning difficulties compared to females (40% vs 20%). Sixty % of patients were Asian compared to 28% in our T1D cohort. BMI at presentation was 31.5 kg/m2 (23 females) and 33.85 kg/m2 (13 males). BMI remained stable for females for the first year after diagnosis but in males increased to 34.6 kg/m2 (n=10, non significant (ns)). At diagnosis, Metformin was started in 38/40 patients although 7 patients reduced the dose and 6 stopped due to side effects. 12/36 patients started also on long-acting insulin (0.28+/-0.17U/kg), in 6 combined with prandial insulin (0.42+/-0.20U/kg). Seven patients started long-acting insulin at a later stage and 6 required prandial insulin too. 1 patient was treated with Sitagliptin. HbA1c at diagnosis (n=27) was 75.2+/- 20mmol/mol, similar for males and females.HbA1c dropped to 55.0+/-17.4mmol/mol after 3 months (P&lt;0.0001), to increase again to 63.0+/-25.8 and 67+/-28 after one (n=25, ns) and 2 years (n=23, ns). Nineteen of 38 patients achieved a HbA1c &lt; 48 at least once, but only 9 of 35 achieved an HbA1c &lt; 48 for a year. Of these, 3 continued to be on insulin and in 1 patient insulin was stopped. Two patients relapsed. Complications were as follows: 11/21 hypertension, 6/28 sleep apnoea, 10/30 raised ALT and 9/24 fatty liver. Conclusion: Learning difficulties in patients with T2D are frequent. Complications of obesity/T2D are common in this cohort. Current treatment does not achieve permanent reduction in BMI and HbA1c in most patients although temporary reduction of HbA1c is possible. New treatment approaches are needed to improve outcomes.

Long acting antipsychotics treatment of schizophrenia: A 24-month prospective study on patient's attitude towards treatment

2017 ◽  
Vol 41 (S1) ◽  
pp. S188-S188
Author(s):  
E. Calderani ◽  
F. Pietrini ◽  
I. Burian ◽  
F. Chiarello ◽  
D. Dahlke ◽  
...  
Keyword(s):  
Rating Scale ◽  
Short Form ◽  
Concomitant Treatment ◽  
Young Mania ◽  
Attitude Inventory ◽  
Schizophrenic Patients ◽  
Competing Interest ◽  
One Year ◽  
Long Acting ◽  
The Impact

IntroductionLong-acting injectable (LAI) second-generation antipsychotics (SGAs) are considered an alternative to oral antipsychotics for schizophrenic patients with low adherence to therapy. However, it is still a matter of debate whether LAI-SGAs are able to significantly improve patient's attitudes towards treatment (ATT) [1].ObjectiveTo investigate the impact of LAI on ATT over 24 months.MethodsNineteen schizophrenic patients were switched from either oral olanzapine (11) or paliperidone (8) to the corresponding LAI. Patients were assessed at baseline (T0), after 6 (T1), 12 (T2) and 24 months (T3). Drug Attitude Inventory-10 (DAI-10) [2] was used to assess ATT. Young Mania Rating Scale (YMRS), Montgomery-Asberg Depression Rating Scale (MADRS), Positive and Negative Syndrome Scale (PANSS), and Short Form Health Survey (SF-36) were used for psychopathology evaluations.ResultsEleven patients reached T3. Eight patients were excluded (4 olanzapine, 4 paliperidone): 4 required a significant change in concomitant treatment, 4 a change of antipsychotic (metabolic comorbidity). No changes in psychopathology occurred between T2 and T3, some scales improved from baseline to T2. DAI-10 mean scores were improved after 12 months, thus not significantly, and were further improved at 24 months (P = .008 vs baseline).ConclusionsATT keeps improving after one year of LAI treatment, unrelated to clinical response.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Efficacy and tolerability of switching to long-acting injectable (LAI) aripiprazole in outpatients with schizophrenia

2016 ◽  
Vol 33 (S1) ◽  
pp. s255-s256
Author(s):  
B. Fernández-Abascal Puente ◽  
M. Juncal Ruiz ◽  
R. Landera Rodríguez
Keyword(s):  
Side Effects ◽  
Treatment Regimen ◽  
Treatment Adherence ◽  
Side Effect ◽  
Negative Symptoms ◽  
Psychotic Symptoms ◽  
Oral Olanzapine ◽  
Insufficient Response ◽  
Competing Interest ◽  
Long Acting

IntroductionSwitching antipsychotics is a therapeutic alternative for managing side-effects, or efficacy and compliance issues.AimTo evaluate the efficacy and tolerability of switching to LAI-aripiprazole in patients who had insufficient response or were intolerant to the previous antipsychotic, or required a more convenient treatment regimen.MethodsThis was a prospective, observational, 6-months study carried out in 45 outpatients with schizophrenia who were clinically stabilized but a switching to another antipsychotic was clinically indicated. Patients who required hospitalization, treatment discontinuation or adding another antipsychotic (including supplementation with oral-aripiprazole) were considered treatment failures. Switching was considered successful if the side-effect/symptom/adherence/convenience improved or, if applicable, disappeared.ResultsPatients aged 38 years, 51% women, and previous antipsychotics comprised: LAI-paliperidone (42%), oral-aripiprazole (22%), oral-olanzapine (11%), oral-risperidone (7%), LAI-risperidone (4%) and others (14%). The efficacy results of the switching are presented in the table. Of the 45 patients, 7 (15%) were considered treatment failures: 3 patients were hospitalized due to recurrence of psychotic symptoms, 2 discontinued LAI-aripiprazole, and 2 required supplementation with oral-aripiprazole (Fig 1).ConclusionsOur results suggest that switching to LAI-aripiprazole is an efficacious strategy for managing some antipsychotic-induced side-effects, persistence of negative symptoms and/or lack of treatment adherence.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Effect of switching to long-acting injectable (LAI) aripiprazole on long-lasting antipsychotic-induced hyperprolactinemia: A report of two cases

2016 ◽  
Vol 33 (S1) ◽  
pp. S579-S579 ◽  
Author(s):  
M. Juncal Ruiz ◽  
B. Fernández-Abascal Puente ◽  
R. Landera Rodríguez
Keyword(s):  
Side Effects ◽  
Outpatient Treatment ◽  
Effective Alternative ◽  
Drug Induced ◽  
Partial Agonism ◽  
Menstrual Function ◽  
Blood Tests ◽  
Competing Interest ◽  
Long Acting ◽  
Brain Condition

IntroductionAntipsychotic-induced hyperprolactinemia (> 29 ng/ml in women) is associated with relevant side-effects.AimWe describe the case of two women aged 50 and 54 years, respectively, diagnosed with schizophrenia who were receiving outpatient treatment with paliperidone depot 100 mg/month and risperidone depot 50 mg/2 weeks, respectively and complained of oligoamenorrhoea and amenorrhoea for at least 6 months.MethodsRoutine blood tests showed hyperprolactinemia of 203.5 ng/ml and 306.2 ng/ml, respectively. The patients were evaluated by the Endocrinology unit and an MRI was performed discarding the presence of any primary brain condition. Both patients were switched to LAI aripiprazole due to its partial agonism of D2-brain receptors. At the time of switching both patients were stable in terms of psychopathology.ResultsChanges in prolactin levels 3 months after switching are shown in the Fig. 1. Two months after switching, both patients regained cyclic menstrual function. After 6 months, they still showed psycopathological stability.ConclusionsSeveral studies have described an improvement of drug-induced hyperprolactinemia after switching to or adding oral aripiprazole. In these two cases, the normalization of prolactin levels and the resolution of oligoamenorrhoea/amenorrhoea were observed as soon as 2–3 months after switching to LAI aripiprazole. These findings suggest that switching to LAI aripiprazole may be an effective alternative for managing antipsychotic-induced hyperprolactinemia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Effect in antipsychotic-induced hyperprolactinemia after switching to long-acting injectable aripiprazole: A 1-year study

2017 ◽  
Vol 41 (S1) ◽  
pp. s815-s816
Author(s):  
M. Juncal Ruiz ◽  
B. Fernández-Abascal Puente ◽  
O. Porta Olivares ◽  
M. Gómez Revuelta ◽  
R. Landera Rodríguez ◽  
...  
Keyword(s):  
Side Effects ◽  
Sexual Dysfunction ◽  
Clinical Improvement ◽  
Drug Induced ◽  
Oral Olanzapine ◽  
Competing Interest ◽  
One Year ◽  
Long Acting ◽  
Almost All

IntroductionAntipsychotic-induced hyperprolactinemia is associated with relevant side effects: short-term as hypogonadism, gynecomastia, amenorrhoea, sexual dysfunction and galactorrhoea; long-term as cardiovascular disease, bone demineralization and breast and prostate tumors.AimsTo evaluate the effect of switching to long-acting injectable aripiprazole on long-lasting antypsychotic-induced hyperprolactinemia.MethodsThis was a prospective observational 1-year study carried out in 125 outpatients with schizophrenia who were clinically stabilized but a switching to another antipsychotic was indicated. We measured the basal prolactine at the start of the study and 1 year after switching to long acting injecatable (LAI) aripiprazole.ResultsIn basal analytic, 48% had hyperprolactinemia (21.8–306.2 ng/mL) and 66.5% of them described side effects: 78% sexual dysfunction (72% men), 11% galactorrhoea (100% women), 5.5% amenorrhoea and 5.5% bone pain (100% women). In 48% of patients with hyperprolactinemia, the previous antipsychotics comprised: LAI-paliperidone (65,7%), oral-risperidone (7%), oral-olanzapine (6.1%), oral-paliperidone (5.2%), LAI-risperidone (4%) and others (12%). One year after switching to LAI-aripiprazole, prolactine levels were lower in all patients and in 85% prolactine levels were normalized. Overall, 72% described a clinical improvement, especially in terms of sexual dysfunction.ConclusionsSeveral studies have described an improvement of drug-induced hyperprolactinemia after switching to or adding oral aripiprazole. In our study, we observed that levels of prolactine were normalized in 85% of patients with a clinical improvement in almost all of cases. These findings suggest that switching to LAI aripiprazole may be an effective alternative for managing antipsychotic-induced hyperprolactinemia due to its partial agonism in D2 brain receptors, especially in tuberoinfundibular pathway.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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