The effectiveness of long-term aripiprazole injections to a patient withparanoid schizophrenia: a case report
DOI:
https://doi.org/10.2478/cpp-2020-0014Keywords:
long-acting injectable (LAI) aripiprazole, paranoid schizophrenia, Abilify Maintena®, psychosisAbstract
Paranoid schizophrenia is a chronic, psychotic disorder which can be treated with long-acting injectable (LAI) antipsychotic drugs. There are risperidone (Risperdal Consta®), olanzapine (Zypadhera®), paliperidone (Xepilon®) and aripiprazole (Abilify Maintena®) currently available.
The aim of this study was to present a case history of the patient to whom monthly injections of aripiprazole effectively prevented both relapses of psychotic symptoms and hospitalizations.
Case report: A 55-year-old male patient with a 13-year history of paranoid schizophrenia has been effectively treated with aripiprazole (LAI) (400mg, every 4 weeks). During the last 8 years of treatment his mental state has been stabilized, without any acute psychotic symptoms and without any anxiety, or violent behaviours. Moreover, there have been no psychotic symptoms, or suicidal thoughts, or tendencies recordered. Therefore, no hospitalization has been required. However, despite the treatment, negative symptoms such as blunted affect, cognitive dysfunction and social withdrawal have been sustained.
Discussion: The available articles on aripiprazole (LAI) treatment indicate that it was effective in reducing the positive and negative symptoms of schizophrenia, as well as reducing the frequency and duration of hospitalization. However, the case report of a patient who has not had relapses of psychotic symptoms and suicidal thoughts and has not been hospitalized during 8 years of treatment with aripiprazole (LAI) has not yet been reported.
Conclusions: Regular, long-term injections of aripiprazole (LAI) are very effective at preventing positive symptoms of schizophrenia development and preventing both suicidal thoughts and hospitalizations. Therefore, treatment with this drug in everyday practice should be increased.
References
1. Fagiolinia A, Agugliab E, Ballerinic A, Callistad G, Carpinielloe B, Clerici M, et al. Real-world effectiveness of long acting aripiprazole: Treatment persistence and its correlates in the Italian clinical practice. Psychiatry Res 2019; 272: 698-706.
2. Madera JJ, Such P, Zhao C, Baker RA. Symptomatic stability with aripiprazole once-monthly: efficacy analyses from acute and long-term studies. Neuropsych Dis and Treat 2019; 15: 1593- 1604.
3. Peters-Strickland T, Baker RA, Such P, Zhang P, Madera JJ. The effect of aripiprazole once-monthly on personal and social functioning: post hoc analyses of acute and long-term studies. Neuropsych Dis and Treat 2019; 15:1659-1669.
4. Jarema M, Wichniak A, Dudek D, Samochowiec J, Bieńkowski P, Rybakowski J. Wskazówki do stosowania leków przeciwpsychotycznych II generacji o przedłużonym działaniu. Psychiatr Pol 2015; 49: 225-241.
5. Shirley M, Perry CM. Aripiprazole (Abilify Maintena®): a review of its use as maintenance treatment for adult patients with schizophrenia. Drugs 2014; 74 :1097-1100.
6. Theodoros T, Taylor M, Chu-Han Huang H, Wang N, Montamari B. Going the distance: reviewing antipsychotic depot or long-acting injectable treatments in Australasia. Australas Psychiatry 2018; 26: 303-306.
7. Fleischhacker WW, Sanchez R, Perry PP, Jin N, Peters-Strickland T, Johnson BR et al. Aripiprazole once-monthly for treatment of schizophrenia: double-blind, randomised, non-inferiority study. Br J Psychiatry 2014; 205: 135-144.
8. Kane JM, Sanchez R, Perry PP, Jin N, Johnson BR, Forbes RA et al. Aripiprazole intramuscular depot as maintenance treatment in patients with schizophrenia: a 52-week, multicenter, randomized, double-blind, placebo-controlled study. J Clin Psychiatry 2012; 73: 617-624.
9. Peters-Strickland T, Baker RA, McQuade RD, Jin N, Eramo A, Perry P et al. Aripiprazole once-monthly 400 mg for long-term maintenance treatment of schizophrenia: a 52-week open-label study. N P J Schizophr 2015; 4: 15039.
10. Kane JM, Peters-Strickland T, Baker RA, Hertel P, Eramo A, Jin N et al. Aripiprazole once-monthly in the acute treatment of schizophrenia: findings from a 12-week, randomized, doubleblind, placebo-controlled study. J Clin Psychiatry 2014; 75: 1254-1260.
11. Mustafa S, Bougie J, Miguelez M, Clerzius G, Rampakakis E, Proulx J et al. Real-life assessment of aripiprazole monthly (Abilify Maintena) in schizophrenia: a Canadian naturalistic non-interventional prospective cohort study. BMC Psychiatry 2019; 19: 114-123.
12. Kane JM, Sanchez R, Zhao J, Duca AR, Johnson BR, McQuade RD et al. Hospitalisation rates in patients switched from oral antipsychotics to aripirazole once-monthly for the management of schizophrenia. J Med Econ 2013; 16: 917-925.
13. Weiden PJ, Kozma C, Grogg A, Locklear J. Partial compliance and risk of rehospitalization among California Medicaid patients with schizophrenia. Psychiatric Serv 2004; 55: 886-91.
14. Mallikaarjun S, Kane JM, Bricmont P, McQuade R, Carson W, Sanchez R et al. Pharmacokinetics, tolerability and safety of aripiprazole once-monthly in adult schizophrenia: an openlabel, parallel-arm, multiple-dose study. Schizophr Res 2013; 150: 281-8.
15. Szulc A, Samochowiec J, Gałecki P, Wojnar M, Heitzman J, Dudek D. Recommendations for the treatment of schizophrenia with negative symptoms. Standards of pharmacotherapy by the Polish Psychiatric Association (Polskie Towarzystwo Psychiatryczne), part 1. Psychiatr Pol 2019; 53: 497-524.
16. Lieberman JA. Dopamine partial agonists: a new class of antipsychotics. CNS Drugs 2004; 18: 251-267.
Downloads
Published
Issue
Section
License
Copyright (c) 2020 Authors

This work is licensed under a Creative Commons Attribution 4.0 International License.