The Study for Switching Strategies from Previous Antipsychotics to Aripiprazole: A One-Year Naturalistic Study

Seo, Tae Yeon; Kang, Min Hee; Lee, Jeong Seop; Bae, Jae Nam; Kim, Chul Eung

Abstract

OBJECTIVE
This study analyzed clinical courses to investigate the effectiveness of strategies switching to aripiprazole. METHODS: Patients confirmed DSM-IV diagnoses of schizophrenia who had been treated with aripiprazoleafter switching from previous antipsychotics were recruited from inpatient and outpatient departments of Inha Hospital from March 2005 to February 2007. We classified patients according to three switching strategies (crosstapering, abrupt-switching, tapering-switching) and, over the course of a one-year period, collected data for intervals during which medications were being switched. RESULTS: A total of 48 patients with an average age of 36.25+/-8.58 years participated in this study. The sample consisted of 20 patients in the cross-tapering group, 23 in the abrupt-switching group, and five in the tapering-switching group. The previous antipsychotics were risperidone, olazapine, amisulpride, quetiapine, and ziprasidone. The reasons for switching included weight gain (26.1%), hyperprolactinemia (23.9%), lack of effectiveness (20.8%), and over-sedation (13.0%). The rates at which patients continued aripiprazole after one year were 55% (11/20) for the cross-tapering group, 48.7% (11/23) for the abrupt-switching group, and 40% (2/5) for the tapering-switching group. In addition, 25% of cross-tapering patients (5/20), 43.5% of abrupt-switching patients (10/23), and 60% of tapering-switching patients (3/5) switched to other antipsychotics. Continuation of aripiprazole was higher in the cross-tapering group than in the abrupt switching group, but this difference did not reach statistical significance (p=0.351). The average aripiprazole retention duration was 10.75+/-3.29 months in the cross-tapering group, 10.39+/-3.29 months in the abrupt-switching group, and 10.00+/-4.77 months in the tapering-switching group. Cross-tapering was associated with a relatively longer retention period, but this difference did not reach statistical significance (p=0.653). CONCLUSION: All three switching strategies were associated with tolerable clinical outcomes after the shift to aripiprazole. The rate and duration of aripiprazole retention was higher in the cross-tapering group than in the abrupt switching group, but this result did not achieve statistical significance.