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Treatment of psychotic symptoms in bipolar disorder with aripiprazole monotherapy: a meta-analysis.

Fountoulakis KN, Gonda X, Vieta E, Schmidt F - Ann Gen Psychiatry (2009)

Bottom Line: The effect was higher for the PANSS-positive subscale (0.28), PANSS-hostility subscale (0.24) and PANSS-cognitive subscale (0.20), and lower for the PANSS-negative subscale (0.12).No data on the depressive phase of bipolar illness exist, while there are some data in favour of aripiprazole concerning the maintenance phase, where at week 26 all except the total PANSS score showed a significant superiority of aripiprazole over placebo (d = 0.28 for positive, d = 0.38 for the cognitive and d = 0.71 for the hostility subscales) and at week 100 the results were similar (d = 0.42, 0.63 and 0.48, respectively).The data analysed for the current study support the usefulness of aripiprazole against psychotic symptoms during the acute manic and maintenance phases of bipolar illness.

View Article: PubMed Central - HTML - PubMed

Affiliation: Third Department of Psychiatry, Aristotle University of Thessaloniki, Thessaloniki, Greece. kfount@med.auth.gr

ABSTRACT

Background: We present a systematic review and meta-analysis of the available clinical trials concerning the usefulness of aripiprazole in the treatment of the psychotic symptoms in bipolar disorder.

Methods: A systematic MEDLINE and repository search concerning clinical trials for aripiprazole in bipolar disorder was conducted.

Results: The meta-analysis of four randomised controlled trials (RCTs) on acute mania suggests that the effect size of aripiprazole versus placebo was equal to 0.14 but a more reliable and accurate estimation is 0.18 for the total Positive and Negative Syndrome Scale (PANSS) score. The effect was higher for the PANSS-positive subscale (0.28), PANSS-hostility subscale (0.24) and PANSS-cognitive subscale (0.20), and lower for the PANSS-negative subscale (0.12). No data on the depressive phase of bipolar illness exist, while there are some data in favour of aripiprazole concerning the maintenance phase, where at week 26 all except the total PANSS score showed a significant superiority of aripiprazole over placebo (d = 0.28 for positive, d = 0.38 for the cognitive and d = 0.71 for the hostility subscales) and at week 100 the results were similar (d = 0.42, 0.63 and 0.48, respectively).

Conclusion: The data analysed for the current study support the usefulness of aripiprazole against psychotic symptoms during the acute manic and maintenance phases of bipolar illness.

No MeSH data available.


Related in: MedlinePlus

Forest plot of aripiprazole effect size against psychotic symptoms in acute mania (PANSS-total data).
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Figure 1: Forest plot of aripiprazole effect size against psychotic symptoms in acute mania (PANSS-total data).

Mentions: The details of these studies (randomised patients, efficacy and safety sample, publications and results) are shown in Table 1. The baseline scores for all outcome scales are shown in Table 2. The similarity of baseline scores across trials and the similar pooled mean justified the pooling of all data concerning each arm across studies irrespective whether the specific study had a placebo or a comparator arm or not. The dropout rates are shown in Table 3. The changes in the PANSS scales scores are shown in Table 4. The effect sizes (d) are shown in Table 5. The side effects frequency is shown in Table 6. The forest plot is shown in Figure 1.


Treatment of psychotic symptoms in bipolar disorder with aripiprazole monotherapy: a meta-analysis.

Fountoulakis KN, Gonda X, Vieta E, Schmidt F - Ann Gen Psychiatry (2009)

Forest plot of aripiprazole effect size against psychotic symptoms in acute mania (PANSS-total data).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2812439&req=5

Figure 1: Forest plot of aripiprazole effect size against psychotic symptoms in acute mania (PANSS-total data).
Mentions: The details of these studies (randomised patients, efficacy and safety sample, publications and results) are shown in Table 1. The baseline scores for all outcome scales are shown in Table 2. The similarity of baseline scores across trials and the similar pooled mean justified the pooling of all data concerning each arm across studies irrespective whether the specific study had a placebo or a comparator arm or not. The dropout rates are shown in Table 3. The changes in the PANSS scales scores are shown in Table 4. The effect sizes (d) are shown in Table 5. The side effects frequency is shown in Table 6. The forest plot is shown in Figure 1.

Bottom Line: The effect was higher for the PANSS-positive subscale (0.28), PANSS-hostility subscale (0.24) and PANSS-cognitive subscale (0.20), and lower for the PANSS-negative subscale (0.12).No data on the depressive phase of bipolar illness exist, while there are some data in favour of aripiprazole concerning the maintenance phase, where at week 26 all except the total PANSS score showed a significant superiority of aripiprazole over placebo (d = 0.28 for positive, d = 0.38 for the cognitive and d = 0.71 for the hostility subscales) and at week 100 the results were similar (d = 0.42, 0.63 and 0.48, respectively).The data analysed for the current study support the usefulness of aripiprazole against psychotic symptoms during the acute manic and maintenance phases of bipolar illness.

View Article: PubMed Central - HTML - PubMed

Affiliation: Third Department of Psychiatry, Aristotle University of Thessaloniki, Thessaloniki, Greece. kfount@med.auth.gr

ABSTRACT

Background: We present a systematic review and meta-analysis of the available clinical trials concerning the usefulness of aripiprazole in the treatment of the psychotic symptoms in bipolar disorder.

Methods: A systematic MEDLINE and repository search concerning clinical trials for aripiprazole in bipolar disorder was conducted.

Results: The meta-analysis of four randomised controlled trials (RCTs) on acute mania suggests that the effect size of aripiprazole versus placebo was equal to 0.14 but a more reliable and accurate estimation is 0.18 for the total Positive and Negative Syndrome Scale (PANSS) score. The effect was higher for the PANSS-positive subscale (0.28), PANSS-hostility subscale (0.24) and PANSS-cognitive subscale (0.20), and lower for the PANSS-negative subscale (0.12). No data on the depressive phase of bipolar illness exist, while there are some data in favour of aripiprazole concerning the maintenance phase, where at week 26 all except the total PANSS score showed a significant superiority of aripiprazole over placebo (d = 0.28 for positive, d = 0.38 for the cognitive and d = 0.71 for the hostility subscales) and at week 100 the results were similar (d = 0.42, 0.63 and 0.48, respectively).

Conclusion: The data analysed for the current study support the usefulness of aripiprazole against psychotic symptoms during the acute manic and maintenance phases of bipolar illness.

No MeSH data available.


Related in: MedlinePlus