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Aripiprazole for Drug-Naive or Antipsychotic-Short-Exposure Subjects With Ultra-High Risk State and First-Episode Psychosis: An Open-Label Study

Liu, Chen-Chung MD, PhD; Chien, Yi-Ling MD; Hsieh, Ming H. MD; Hwang, Tzung-Jeng MD, PhD; Hwu, Hai-Gwo MD; Liu, Chih-Min MD, PhD

Journal of Clinical Psychopharmacology:
doi: 10.1097/JCP.0b013e31827cb017
Original Contributions
Abstract

Introduction: This study aimed to observe treatment response using aripiprazole for subjects with ultra-high risk (UHR) state of psychosis or at their first-episode psychosis (FEP) who were drug-naive or only have received antipsychotic therapy temporarily.

Methods: All patients received aripiprazole 3.75 mg/d initially to test tolerability and increased to 7.5 mg during the first 2 weeks. A flexible dosing strategy based on clinical improvement and tolerability with a target dose 15 mg/d by the end of the fourth week. Clinical severity was assessed by a Mandarin version of the positive and negative syndrome scale for schizophrenia at baseline, the end of the second and the fourth week. Adverse reactions were recorded by a log, and concomitant medications were allowed.

Results: A total of 20 FEP and 11 UHR patients, including 18 drug-naive (11 FEP and 7 UHR) and 13 antipsychotic-short-exposure patients (9 FEP and 4 UHR), participated in and 29 completed the study. Most of them received aripiprazole no more than 7.5 mg/d at end point with favorable response, although many of them reported adverse events. Both UHR and FEP patients got significant decrease of positive symptom scores in a similar pattern. Both groups did not show significant changes in negative symptom scores.

Conclusion: The treatment response of UHR patients is likely a continuum from that of the FEP patients. Low-dose aripiprazole revealed potential efficacy for patients with less severe psychopathology, at putative prodromal or early state of psychosis, yet still was accompanied by adverse events while treating this mostly drug-naive population.

Author Information

From the Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.

Received October 18, 2011; accepted after revision June 4, 2012.

Reprints: Chih-Min Liu, MD, PhD, Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No. 7 Chung-Shan S. Rd, Taipei 10002, Taiwan (e-mail: cmliu1968@ntu.edu.tw).

This study was supported by National Science Council (NSC), Taiwan Grants NSC 97-2321-B-002-041, NSC 98-2321-B-002-008, and NSC 99-2321-B-002-038.

© 2013 Lippincott Williams & Wilkins, Inc.