A UK panel consensus on the initiation of aripiprazole for the treatment of bipolar mania

Abstract

Objective. The objective of this consensus paper is to provide practical guidance on why and how aripiprazole, with its distinct pharmacological and side effect profile, should be used for treatment of acute bipolar mania. Methods. An advisory panel of UK healthcare professionals, with extensive experience of prescribing aripiprazole for acute bipolar mania, met to discuss its use in this setting. Results. The panel agreed that aripiprazole is effective in treating bipolar mania when prescribed and dosed appropriately, in both the short and long term, as monotherapy or in combination with a mood stabilizer. Unlike other atypical agents, aripiprazole has antimanic effects that are not associated with sedation, which is beneficial for patients, particularly in the long term. If rapid tranquillization is required when initiating aripiprazole in acutely disturbed patients, short-term coprescription of a benzodiazepine is recommended. Most side effects associated with aripiprazole occur within the first 1−3 weeks and are usually transient and easily treatable. Aripiprazole poses low risk of metabolic side effects, sexual dysfunction, and anhedonia, which can facilitate treatment adherence and help improve clinical outcomes. Conclusions. Aripiprazole is an effective first-line treatment for acute bipolar mania with a favorable safety/tolerability profile.

Key Words::

• Acute mania
• aripiprazole
• atypical antipsychotic
• bipolar disorder
• bipolar mania

Statement of Interest

The Consensus Group Meeting for the development of this publication was organized and funded by Bristol-Myers Squibb and Otsuka Pharmaceuticals. Editorial support for the preparation of this publication was provided by mXm Medical Communications, and funding for this editorial support was provided by Bristol-Myers Squibb and Otsuka Pharmaceuticals. This publication is based on the discussions from the Consensus Group Meeting, with all authors contributing to all drafts of the article. The opinions expressed in this article are the independent consensus views of the authors and have not been influenced by third-party sponsorship.

Luiz Dratcu has received honoraria from Bristol-Myers Squibb/Otsuka and Lundbeck. Sotonte Bobmanuel has received honoraria from Bristol-Myers Squibb/Otsuka and AstraZeneca. Wendy Davies has received honoraria from Bristol-Myers Squibb/Otsuka, Lundbeck and Janssen-Cilag. Alan Farmer has received honoraria from Bristol-Myers Squibb/Otsuka, Lundbeck and Janssen-Cilag. Mohan George has received honoraria from Bristol-Myers Squibb/Otsuka, AstraZeneca, Janssen-Cilag and Lundbeck and has been a speaker or advisory board member for Bristol-Myers Squibb/Otsuka and AstraZeneca. Tanvir Rana has received honoraria from Bristol-Myers Squibb/Otsuka, AstraZeneca, Lilly and Janssen-Cilag. Mala Singh has received honoraria from Bristol-Myers Squibb/Otsuka and Servier. Martin Turner has received speaker honoraria, been an invited member of advisory boards, and participated in clinical trials on behalf of several pharmaceutical companies including Bristol-Myers Squibb/Otsuka, Lundbeck and Janssen-Cilag.