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Int J Psychiatry Clin Pract ; 16(4): 244-58, 2012 Oct.
Article in English | MEDLINE | ID: mdl-22809129

ABSTRACT

OBJECTIVE: The objective of this consensus paper is to provide practical guidance on why and how aripiprazole, with its distinct pharmacological and side effect profile, should be used for treatment of acute bipolar mania. METHODS: An advisory panel of UK healthcare professionals, with extensive experience of prescribing aripiprazole for acute bipolar mania, met to discuss its use in this setting. RESULTS: The panel agreed that aripiprazole is effective in treating bipolar mania when prescribed and dosed appropriately, in both the short and long term, as monotherapy or in combination with a mood stabilizer. Unlike other atypical agents, aripiprazole has antimanic effects that are not associated with sedation, which is beneficial for patients, particularly in the long term. If rapid tranquillization is required when initiating aripiprazole in acutely disturbed patients, short-term coprescription of a benzodiazepine is recommended. Most side effects associated with aripiprazole occur within the first 1-3 weeks and are usually transient and easily treatable. Aripiprazole poses low risk of metabolic side effects, sexual dysfunction, and anhedonia, which can facilitate treatment adherence and help improve clinical outcomes. CONCLUSIONS: Aripiprazole is an effective first-line treatment for acute bipolar mania with a favorable safety/tolerability profile.


Subject(s)
Antipsychotic Agents/therapeutic use , Bipolar Disorder/drug therapy , Piperazines/therapeutic use , Quinolones/therapeutic use , Acute Disease , Anhedonia/drug effects , Antipsychotic Agents/adverse effects , Antipsychotic Agents/pharmacology , Aripiprazole , Drug Administration Schedule , Drug Therapy, Combination , Humans , Long-Term Care , Metabolic Diseases/chemically induced , Metabolic Diseases/prevention & control , Patient Participation , Piperazines/adverse effects , Piperazines/pharmacology , Psychomotor Agitation/prevention & control , Quinolones/adverse effects , Quinolones/pharmacology , Randomized Controlled Trials as Topic , Recovery of Function , Sexual Dysfunction, Physiological/chemically induced , Sexual Dysfunction, Physiological/prevention & control , Treatment Outcome
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