Treatment and prevention of mania in bipolar I disorder: focus on aripiprazole

Abstract

Aripiprazole is a second-generation antipsychotic with a unique pharmacologic receptor profile that has efficacy in the treatment and prevention of mania in bipolar I disorder. This article reviews the evidence supporting treatment of adults with bipolar I disorder using aripiprazole as monotherapy or adjunctively during acute mania and its utility as an intramuscular agent for agitation in manic patients. Results from one of the longest bipolar maintenance trials which support aripiprazole as a prophylactic mood stabilizer, specifically against manic relapses, will be discussed as well as a post-hoc analysis that suggests efficacy for rapid cycling bipolar disorder. Safety and tolerability issues, patient-focused perspectives and aripiprazole’s place in therapy for bipolar mania will be covered.

Keywords:

• bipolar disorder
• mania
• prevention
• aripiprazole
• rapid cycling

Disclosures

Cleveland Clinic maintains policies requiring that certain disclosures of financial interests accompany manuscripts submitted for publication. These financial interests with companies must be disclosed by co-authors from Cleveland Clinic whose research is sponsored by the companies or whose products (or direct and primary competitor’s products) are discussed in the manuscript. In accordance with this Cleveland Clinic policy, I am disclosing that I have served within the past year or will serve in the coming year in the following role(s) in connection with the company(ies) listed below, which either sponsors research described in this manuscript or whose products (or direct and primary competitors’ products) are described in this manuscript:

Speaker: AstraZeneca, Bristol Myers Squibb, Pfizer, Sepracor, Wyeth.

Member of Scientific Advisory Board: AstraZeneca.

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