Aripiprazole syndrome

Hyperprolactinemia in women results in the amenorrhea-galactorrhea syndrome and infertility in men, loss of libido, impotence, and infertility may result. Hyperprolactinemia may cause osteoporosis, particularly in women. If dose reduction is not indicated, or ineffective in controlling this pattern, switching to one of the atypicals that do not raise prolactin levels, eg, aripiprazole, may be indicated. 

Chakraborty N, Johnston T. Aripiprazole and neuroleptic malignant syndrome. Int Clin Psychopharmacol 2004 19(6) 351-3. 

Mendhekar DN. Aripiprazole-induced rabbit syndrome. Aust N Z J Psychiatry 2004 38(7) 561. 

ARIPIPRAZOLE, HALOPERIDOL, CLOZAPINE, PIMOZIDE, RISPERIDONE, SERTINDOLE PROTEASE INHIBITORS Possibly T levels of antipsychotic Inhibition of CYP3A4- and/or CYP2D6-mediated metabolism Avoid co-administration of clozapine with ritonavir, and pimozide or sertindole with protease inhibitors. Use other antipsychotics with caution as 1 dose may be required with risperidone, watch closely for extrapyramidal side-effects and neuroepileptic malignant syndrome... 

Adverse Neurological Effects Many neurological syndromes, particularly involving the extrapyramidal motor system, occur following the use of most antipsychotic drugs, especially with the high-potency D -receptor antagonists (tricyclic piperazines and butyrophenones). Acute adverse extrapyramidal effects are less likely with aripiprazole, clozapine, quetiapine, thioridazine, and ziprasidone, or low doses of olanzapine or risperidone. 

Fluoxetine and probably paroxetine may cause clinically significant increases in aripiprazole levels. The concurrent use of aripiprazole with SSRIs or venlafaxine has led to adverse effects such as the neuroleptic malignant syndrome and extrapyramidal symptoms. 

The concurrent use of aripiprazole and SSRIs can be useful, but it is important to remember to adjust the dose if paroxetine or fluoxetine are started or stopped, and be aware that, rarely, adverse effects such as extrapyramidal symptoms and the neuroleptic malignant syndrome may develop. 

Duggal HS, Kithas J. Possible neuroleptic malignant syndrome with aripiprazole and fluoxetine./I (2005) 162, 397-8. 

Aripiprazole Of 125 patients who were stabilized on aripiprazole for 6-18 weeks before double-blind random assignment to aripiprazole or placebo for 26 weeks, 45 (36%) met criteria for metabolic syndrome at entry [38 ]. The proportions of patients with metabolic syndrome were similar in the placebo and aripiprazole groups at both baseline and week 26. There were no significant changes in any of the individual components of metabolic syndrome between aripiprazole- and placebo-treated patients during maintenance phase treatment. 

Restless legs syndrome has been attributed to aripiprazole [59 ]. 

Rabbit syndrome has been reported during treatment with aripiprazole [61 ]. 

Neuroleptic malignant syndrome has been previously described in association with aripiprazole [SEDA-31, 76 SEDA-33,101], and new cases have been reported [62, 63, 64 ]. 

Restless leg syndrome has been associated with olanzapine in three cases, in which it started after the beginning of treatment with olanzapine and resolved after withdrawal all three patients were subsequently treated with other atypical antipsychotic drugs (risperidone, quetiapine, or aripiprazole) without recurrence [105 ]. 

Kemp DE, Calabrese JR, Tran QV, Pikalov A, Eudicone JM, Baker RA. Metabohc syndrome in patients emolled in a clinical trial of aripiprazole in the maintenance treatment of bipolar I disorder a post hoc analysis of a randomized, double-blind, placebo-controlled trial. J Oin Psychiatry 2010 71 1138-. ... 

Bolanos-Vergaray J, Obaya JC, Gonzalez R, Echeverri C, Piquer P. Restless legs syndrome due to aripiprazole. Eur J Clin Pharmacol 2011 7 39-40. 

Caykoylu A, Ekinci O, Kuloglu M, Deniz O. Aripiprazole-induced rabbit syndrome a case report. J Psychopharmacol... 

Patel MK, Brunetti L. Neuroleptic malignant syndrome secondary to aripiprazole initiation in a clozapine-intolerant patient. Am J Health Syst Pharm 2010 67 1254—9. 

Dassa D, Drai-Moog D, Samuelian JC. Neuroleptic malignant syndrome with the addition of aripiprazole to clozapine. Prog Neuropsychopharmacol Biol Psychiatry 2010 34 427-8. 

Gahr M, Orth M, Abler B. Neuroleptic malignant syndrome with aripiprazole in Huntington s disease. Mov Disord 2010 25 2475-6. 

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... 

Nervous system Aripiprazole has been previously associated with neuroleptic malignant syndrome but with doubts about the validity of the diagnoses. However, postmarketing pharmacovigilance schemes in Australia have collected a higher proportion of cases of neuroleptic malignant syndrome with aripiprazole compared with the total number of reports received for... 

Four SGA long-acting injections are currently available risperidone microspheres, olanzapine pamoate, paliperidone palmitate and aripiprazole extended-release injection. The extended-release characteristics are achieved differently with each drug. A case analysis of clinical frials with olanzapine pamoate (2000-2008) reported an occurrence of postinjection delirium/sedation syndrome in approximately 0.07% of injections or 1.4% of patients [78 ]. A review of the published literature and clinical trial databases for olanzapine pamoate, risperidone microspheres and paliperidone palmitate found only one other case of postinjection delirium/sedation syndrome occurring in a patienf on placebo in a paliperidone palmitate trial. In four randomised, double-blind, placebo-controlled trials of paliperidone palmitate, the most common treatment-emergent adverse event was somnolence/sedation overall treatment discontinuation rates due to adverse events were similar to placebo. 

Nervous system Neuroleptic malignant syndrome is described with aripiprazole in an adolescent with a history of impulsive, disorganised and bizarre behaviour [91 ]. 

A 15-year-old male titrated to 20 mg daily of aripiprazole over a 4-week period developed neuroleptic malignant syndrome which was successfully treated with bromocriptine he also showed signs on MRI of posterior reversible encephalopathy syndrome which can be associated with neuroleptic malignant syndrome. 

A case of restless legs syndrome occurring in a 34-year-old female within 1 week of starting clozapine that responded to the addition of aripiprazole (partial dopamine agonist) is reported [111 ]. 

Riala K, Lahti A, Anttila E, Rasanen P. Aripiprazole-related severe neiuoleptic malignant syndrome with deep coma and organic brain changes in an antipsychotic-naive adolescent boy. J Qin Psychopharmacol 2013 33(l) 126-7. 

Raveendranathan D, Shiva L, Venkatasubramanian G, Rao MG, VarambaUy S, Gangadhar BN. Clozapine-induced restless legs syndrome treated with aripiprazole. J Neuropsych Clin Neurosci 2013 25(2) E62-3. 

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