Starting aripiprazole long-acting-once-a-month early in treatment: why, how and for whom? Expert consensus and practical recommendations by a panel of Italian clinicians

ABSTRACT

Introduction: Aripiprazole long acting once-monthly (AOM) is approved for the treatment of schizophrenia in adults. Despite recent evidence of AOM efficacy in the acute treatment of schizophrenia, it is recommended that AOM should be started once the acute symptoms are controlled and patients are stabilized. However, there currently are no definitive guidelines exactly describing when a patient is to be considered stabilized enough to start AOM and which the patients are for whom an early AOM start is to be preferred.

Areas covered: A panel of Italian clinicians experienced with real world use of AOM met to discuss the scenarios where an early (i.e., immediately after controlling the acute symptoms) start of AOM may be suggested. Real life clinical experiences were shared and a consensus was reached.

Expert opinion: There are cases when the risks/benefits ratio suggests to start AOM early, i.e. immediately after the acute symptoms have been stabilized, as opposed to starting it several days/weeks after the stabilization of acute symptoms. Clinical pearls, guidelines and opinions are provided.

KEYWORDS:

• Aripiprazole
• consensus
• early
• long acting
• starting

Declaration of interest

S De Filippis is/has been consultant and/or a speaker for Angelini, Janssen, Lundbeck, Molteni, Otsuka, Ucb. A Fagiolini is /has been a consultant and/or a speaker and/or has received research grants from Allergan, Angelini, Astra Zeneca, Bristol-Myers Squibb, Boehringer Ingelheim, Pfizer, Eli Lilly, Ferrer, Janssen, Lundbeck, Novartis, Otsuka, Roche. C Tomasetti is /has been a consultant and/or a speaker and/or has received research grants from Otsuka, Lundbeck, Astra Zeneca, Roche, Janssen. V Villari is/has been consultant and/or a speaker for Abbott-Ravizza, Angelini, Astra Zeneca, Bristol Mayer Squibb, Eli Lilly, Italfarmaco, Janssen Cilag, Lundbeck, Otsuka, Pfeitzer, Sanofi-Aventis, and Wheyth.

Otsuka Pharmaceuticals Italy S.r.l and Lundbeck Italia SpA, sponsored the expert meeting but did not have any role in generating recommendations nor did they sponsor the writing of this manuscript. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper is not funded.