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Have you found aripiprazole effective for treatment of psychosis and bipolar mania in practice?

Aripiprazole has FDA approval for treatment of schizophrenia and both acute and mixed episodes of bipolar disorder. In practice, do you find that it is effective for these conditions? Are there patient characteristics that make it a more or less favorable option?
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When do you use aripiprazole as first-line therapy for psychosis?

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5 Answers
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Psychiatry · Wake Forest University School of Medicine
Answered on

While aripiprazole is approved for schizophrenia, I rarely use it for treating this condition. I do not find that it is effective enough to treat true psychotic symptoms when compared to almost all other SGAs. The same goes for bipolar mania. Instead, I tend to use aripiprazole for less severe cases...

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Psychiatry · Pennsylvania Psychiatric Institute
Answered on

I work in a first-episode psychosis coordinated specialty care clinic, and I use aripiprazole frequently for both schizophrenia and bipolar I disorder. I agree it can be less rapidly effective for acute positive symptoms of psychosis or acute symptoms of mania than some other antipsychotics because ...

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Psychiatry · Tufts University, School of Medicine
Answered on

In a 2023 article published in Focus by Keramatian et al., PMID 38695002, the International Society for Bipolar Disorders (ISBD) created guidelines for the treatment of bipolar disorder, and aripiprazole was considered to be a first-line treatment for acute mania.

From my read (I'll admit, I read the...

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Psychiatry · University of New Mexico Medical School
Answered on

It is highly case-dependent. In more moderate to severe cases of either, I have some reservations. We use a lot of long-acting injectables at my academic hospital, including aripiprazole. Over the years, I have had a number of cases who were readmitted and were apparent aripiprazole failures. If the...

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Psychiatry · Massachusetts General Hospital / Harvard Medical School
Answered on

I use aripiprazole very frequently in my inpatients, who often come to us with recurrent catatonia as a consequence of SCZ or BPAD and comorbidities (TBI, ASD, MJ use, AUD, etc.). I like it a lot, especially the option to place the Initio + Aristada LAI induction all at once, with no further oral br...

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