Depression aripiprazole

Conventional antipsychotic drugs such as chlorpromazine and haloperidol have long been used in the treatment of acute mania. More recently, atypical antipsychotic drugs including aripiprazole, olanzapine, quetiapine, risperidone, and ziprasi-done have been approved for the treatment of bipolar mania or mixed mood episodes as monotherapy or in combination with mood-stabilizing drugs.25 Aripiprazole and olanzapine are also approved for maintenance therapy. The combination of olanzapine and fluoxetine is approved for treatment of bipolar depression. Quetiapine is approved for treatment of... 

Lithium, divalproex sodium (valproate), aripiprazole, olanzapine, que-tiapine, risperidone, and ziprasidone are currently approved by the FDA for treatment of acute mania in bipolar disorder. Lithium, olanzapine, and lamotrigine are approved for maintenance treatment of bipolar disorder. Quetiapine is the only antipsychotic that is FDA approved for bipolar depression. 

Among these choices, bnspirone is preferred if the patient is also experiencing anxiety. If the patient is depressed and agitated, a SSRI should be tried first. Second line choices inclnde carbamazepine (Tegretol) or one of the atypical antipsychot-ics—ziprasidone (Geodon), risperidone (Risperdal), olanzapine (Zyprexa), quetiap-ine (Seroquel), or aripiprazole (Abilify) can be tried. If psychotic symptoms are present, one of the atypical antipsychotics should be tried first. 

Another group of mood-stabilizing drugs that are also anticonvulsant agents have become more widely used than lithium. These include carbamazepine and valproic acid for the treatment of acute mania and for prevention of its recurrence. Lamotrigine is approved for prevention of recurrence. Gabapentin, oxcarbazepine, and topiramate are sometimes used to treat bipolar disorder but are not approved by FDA for this indication. Aripiprazole, chlorpromazine, olanzapine, quetiapine, risperidone, and ziprasidone are approved by FDA for the treatment of manic phase of bipolar disorder. Olanzapine plus fluoxetine in combination and quetiapine are approved for the treatment of bipolar depression. 

Aripiprazole Blockade of 5HT2A receptors > blockade of D2 receptors Some a blockade (clozapine, risperidone, ziprasidone) and M-receptor blockade (clozapine, olanzapine) variable receptor blockade (all) Schizophrenia—improve both positive and negative symptoms bipolar disorder (olanzapine or risperidone adjunctive with lithium) agitation in Alzheimer s and Parkinson s (low doses) major depression (aripiprazole) Toxicity Agranulocytosis (clozapine), diabetes (clozapine, olanzapine), hypercholesterolemia (clozapine, olanzapine), hyperprolactinemia (risperidone), QT prolongation (ziprasidone), weight gain (clozapine, olanzapine)... 

Papakostas, G. I., Petersen, T. J., Kinrys, G., Bums, A. M., Worthington, J. J., Alpert, J. E., Fava, M. Nierenberg, A. A. (2005). Aripiprazole augmentation of selective serotonin reuptake inhibitors for treatment-resistant major depressive disorder. J. Clin. Psychiatry, 66, 1326-1330. 

Although relatively little has thus far been written about it, the newer neuroleptics can also cause akinesia, depression, psychosis, and suicidality. Aripiprazole (Abilify) has already been reported to cause or worsen psychosis (Grover et al., 2006 Raja, 2007). I have seen several cases in which olanzapine (Zyprexa) has caused zombielike behavior and profound depression. As chapter 2 also documented, all of the newer neuroleptics, including Risperdal, Geodon, and Seroquel, suppress dopaminergic function (dopamine D2), the most probable neurochemical cause of these clinical states (Wu et al., 2007). 

An overdose of 195 mg (17.1 mg/kg) of aripiprazole in a 2.5 year-old child caused nervous system depression that did not require respiratory support but persisted for almost 2 weeks, because of the long half-life of aripiprazole there were no significant cardiovascular effects (18). 

Atypical antipsychotics such as aripiprazole, olanzapine, que-tiapine, risperidone, and ziprasidone are effective as monotherapy or adjunctive therapy with lithium and valproate in the treatment of acute mania. Some antipsychotics have the potential to cause adverse effects such as extrapyramidal reactions, sedation, depression, emotional blunting, sexual dysfunction, weight gain, and orthostatic hypotension. Prophylactic use of antipsychotics may be needed for some patients with recurrent mania or mixed states, but the risks versus benefits must be weighed because of long-term adverse effects (e.g., obesity, type 2 diabetes, hyperlipidemia, hyperprolactinemia, cardiac disease, and tardive dyskinesia). ... 

Likewise, in a reanalysis of data from two identical aripiprazole augmentation studies in patients with major depressive disorder there was no increased risk of suicide events [66. Patients with an inadequate response to antidepressant drug treatment for 8 weeks were randomly assigned to adjunctive placebo (n = 366) or adjunctive aripiprazole 2-20 mg/ day ( = 371) for 6 weeks. There were no treatment-emergent, suicide-related adverse events with aripiprazole two patients who took placebo had at least one adverse event related to suicide (both suicidal ideation). 

Drug-drug interactions SSRIs Aripiprazole had no effects on the pharmacokinetics of escitalopram, fluoxetine, paroxetine, sertraline, or venlafaxine either in healthy subjects ( =63) or in patients with major depressive disorder ( =498) [69. Point estimates for mean plasma concentration ratios indicated no substantial effect of aripiprazole on any antidepressant escitalopram 0.97 (0.91-1.03), fluoxetine 1.18 (1.05-1.32), paroxetine 0.73 (0.60-0.89), sertraline 0.96 (0.89-1.04), or venlafaxine 0.97 (0.89-1.05). 

Boulton DW, Balch AH, Royzman K, Patel CG, Berman RM, Mallikaarjun S, Reeves RA. The pharmacokinetics of standard antidepressants with aripiprazole as adjunctive therapy studies in healthy subjects and in patients with major depressive disorder. J Psychopharmacol 2010 24 537-46. 

Wei C Yinqiao Pian, 771 nervousness bofutsushosan, 774 Ephedra, 11A liraglutide, 693 nervous system depression chloroform, 195 prilocaine, 216 rupatadine, 274-5 neural tube defects caffeine, 6-7 neurodevelopment delay amiodarone, 294 neuroexdtation pethidine (meperidine), 151 neuroleptic malignant syndrome aripiprazole, 61 lithium, 27... 

Observational studies In a 6-week, prospective, unrandomized, open study in 20 patients with acute bipolar depression, aripiprazole up to a maximum of 30 mg/ day improved Montgomery-Asberg Depression Rating Scale (MADRS) and Mania Rating Scale (MRS) scores significantly [64 ]. The most fi-equent adverse reactions were nausea and akathisia two patients withdrew because of akathisia. 

In an open 16-week study of the efficacy and tolerability of aripiprazole in 85 patients with bipolar disorder and acute depression inadequately responsive to a mood stabilizer there were significant reductions in mean MADRS and Clinical Global Impression-Severity (CGI-S) scales [65 ]. Three patients withdrew because of adverse reactions, the most common of which was akathisia, which occurred in 21% of subjects there was also a statistically non-significant weight gain (0.9 kg). 

Trivedi MH, Thase ME, Fava M, Nelson CJ, Yang H, Qi Y, Tran QV, Pikalov A, Carlson BX, Marcus RN, Berman RM. Adjunctive aripiprazole in major depressive disorder analysis of efficacy and safety in patients with anxious and atypical features. J Clin Psychiatry 2008 69(12) 1928-36. 

Dunn RT, Stan VA, Chriki LS, Filkowski MM, Ghaemi SN. A prospective, open-label study of aripiprazole mono- and adjunctive treatment in acute bipolar depression. J Affect Disord 2008 110(1-2) 70-4. 

Ability is the trade name for aripiprazole, a drug used to treat depression, schizophrenia, and bipolar disorders, (a) Rank the N atoms in aripiprazole in order of increasing basicity, (b) What product is formed when aripiprazole is treated with HCI ... 

A 19-year-old white male with a history of multiple drug abuse, psychosis, depression and attention-deficit hyperactivity disorder used an unknown quantity of MXE IV for abuse shortly before he was discharged from an inpatient detoxification facility. He was on bupropion, aripiprazole and chlorprothixene. About 30 min after the injection, he presented to the ER of the hospital with extreme agitation, ataxia and semistuporous state. 

A systematic review and meta-analysis of second-generation antipsychotics (SGAs) in the treatment of bipolar depression found considerable clinical and statistical heterogeneity of the data with a preponderance of quetiapine studies (9) compared to olanzapine (1) and aripiprazole (2) [22 ]. Adverse events were defined differently and... 

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