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Mood Disorders
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Madeleine A. Becker, Tal E. Weinberger, Leigh J. Ocker
In a large study utilizing a nationwide Medicaid database, pregnancies exposed to first generation antipsychotics and individual second generation antipsychotics (aripiprazole, quetiapine, olanzapine, ziprasidone and risperidone) were compared to unexposed pregnancies. No increased risk of cardiac malformations or overall congenital malformations was found for any of the individual agents, with the exception of risperidone, which demonstrated a relative risk of 1.26 for both cardiac malformations and overall congenital malformations compared to unexposed pregnancies, after correction for potential confounders, including indication. This small increase in risk with risperidone should be interpreted with caution and requires replication [157]. There is currently substantial reassuring data regarding first trimester exposure to quetiapine, olanzapine, and aripiprazole which do not suggest a clinically meaningful increased risk of teratogenicity. While no adverse outcomes are apparent from the literature, data regarding other pregnancy outcomes such as miscarriage, preterm delivery, small for gestational age, neonatal adaptation, and neurodevelopmental outcomes after perinatal second generation antipsychotic exposure are insufficient as yet to draw definitive conclusions [158, 159].
Drugs Affecting the Central Nervous System
Published in Radhwan Nidal Al-Zidan, Drugs in Pregnancy, 2020
Risk Summary: It should be used with caution because the pregnancy experience in humans is limited, and the reproduction studies in animals have shown risk associated with the use of Aripiprazole.
Antimanic Drugs
Published in Sahab Uddin, Rashid Mamunur, Advances in Neuropharmacology, 2020
Aman Upaganlawar, Abdulla Sherikar, Chandrashekhar Upasani
The potential harmful effects of aripiprazole include neuroleptic malignant syndrome, tardive dyskinesia, stroke, hyperglycemia, orthostatic hypotension, seizure, cognitive and motor impairment, and so on (Bristol-Myers, 2005).
Aripiprazole for the treatment of schizophrenia: Recommendations of a panel of Spanish experts on its use in clinical practice
Published in International Journal of Psychiatry in Clinical Practice, 2023
David Fraguas, David Almenta Gallego, Sergio Arques-Egea, Marcos Gómez-Revuelta, Carlos Gómez Sánchez-Lafuente, Daniel Hernández Huerta, Daniel Núñez Arias, Beatriz Oda Plasencia-García, Carlos Parro Torres, Samuel Leopoldo Romero-Guillena, Elena Ros Cucurul, Cecilio Alamo
Because schizophrenia treatment must be individualised according to the characteristics of each patient, generalisations must be pondered carefully. However, the experience of the panel of experts in the use of aripiprazole was intended to cover the aspects of the use of this antipsychotic partially described in the literature. To summarise, we recommend considering aripiprazole as the first treatment option in the early stages of schizophrenia and in patients with significant affective symptoms, owing to its good tolerability and low adverse effect profile. Also, switching to aripiprazole LAI should be contemplated in all candidate patients because of its superior adherence that prevents long-term relapses and improves quality of life. Importantly, switches from other antipsychotics should take into account the patient’s previous antipsychotic history and, in particular, its previous exposure to aripiprazole. The literature review performed to achieve this consensus revealed the absence of controlled studies regarding the use of aripiprazole in actual clinical practice. Therefore, we urge the scientific community to carry out rigorous quality studies to validate or refute the clinical recommendations presented here.
A descriptive study of aripiprazole, brexpiprazole, and cariprazine exposures in children ages 0 to 5 years reported to United States poison centers
Published in Clinical Toxicology, 2023
Nicholas Husak, Thomas W. Laudone, James B. Leonard
Olfson and colleagues [3] described several-fold increases in prescriptions for antipsychotics in children, adolescents, and adults between the year 1993 and 2009. Prescriptions for children increased from 0.24 per 100 persons to 1.83 per 100 persons. Aripiprazole is one of the most widely prescribed antipsychotics, and use in children and adolescents has become more prominent since being approved in 2007. Aripiprazole is currently approved for treating schizophrenia, bipolar disorder, Tourette’s syndrome, and irritability associated with autistic disorder in children and adolescents. More than 500,000 children and adolescents aged 6–17 years of age between June 2014 and November 2016 received aripiprazole [4]. Increased prescribing and availability are strongly associated with increased pediatric ingestions [5].
Aripiprazole for the treatment of Tourette syndrome
Published in Expert Review of Neurotherapeutics, 2021
Joanna H. Cox, Andrea E. Cavanna
A full picture of the multiple mechanisms of action of aripiprazole is yet to be fully elucidated, although it is thought to act on various receptors within the dopaminergic and serotonergic pathways. Its primary mechanism of action at the level of D2 dopamine receptors is thought to affect mesolimbic and mesocortical dopaminergic pathways [53]. There is also evidence that aripiprazole works as a partial receptor agonist at the 5-HT1A serotonergic receptor [54]. Serotoninergic underactivity has been implicated in the pathophysiology of depression and anxiety, and thus partial agonism at this level is likely to improve affective symptoms, which are prominent in both psychotic disorders and neurodevelopmental disorders including TS. Aripiprazole has also been shown to act as an antagonist at the 5-HT2A serotonergic receptor. In addition to actions on the dopaminergic and serotonergic pathways, animal studies have shown that aripiprazole acts on a wide variety of other relevant central nervous system receptors including those involved in adrenergic and histaminergic pathways.