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Efficacy and safety of aripiprazole for the treatment of schizophrenia: an overview of systematic reviews

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Abstract

Purpose

To conduct an overview to summarize the efficacy and safety of aripiprazole for the treatment of schizophrenia.

Methods

A literature search was performed in PubMed, the Cochrane Library, LILACS, and the Centre for Reviews and Dissemination, for articles published until March 31, 2017. We included systematic reviews with meta-analyses of randomized controlled trials assessing the efficacy, and/or the safety of aripiprazole, for patients with schizophrenia. Two authors independently performed the study selection, data extraction, and quality assessment. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach and the Risk of Bias in Systematic Review (ROBIS) tool were used to appraise the quality of evidence and the risk of bias in the reviews, respectively.

Results

Fourteen studies fulfilled the inclusion criteria. Aripiprazole showed efficacy similar to that of both typical and atypical antipsychotic drugs (except olanzapine and amisulpride). Aripiprazole caused significantly lower weight gain and alterations in glucose and cholesterol levels, as compared to clozapine, risperidone, and olanzapine. In addition, aripiprazole caused significantly fewer general extrapyramidal side effects, less use of antiparkinsonian drugs, and akathisia, compared with typical antipsychotic drugs and risperidone. The overall quality of evidence in the reviews ranged from “very low” to “moderate,” principally because of the risk of bias of original trials, inconsistency, and imprecision in the outcomes. According to the ROBIS tool, there are four reviews with “high” risk of bias and five with “unclear” risk of bias.

Conclusions

Aripiprazole exhibited efficacy similar to that of other antipsychotic drugs and a better safety profile than that of typical (i.e., less some extrapyramidal side effects) and atypical (i.e., less metabolic changes) antipsychotic drugs.

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Author information

Authors and Affiliations

  1. Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of Sao Paulo, Av. Prof. Lineu Prestes, 580 - Conj. das Químicas - Bloco 13 - Cidade Universitária Butantã, Sao Paulo, Brazil

    Esther Letícia Amorim Ribeiro, Tácio de Mendonça Lima, Sílvia Storpirtis & Patricia Melo Aguiar

  2. Psychiatry Clinic, University Hospital of University Sao Paulo, Sao Paulo, Brazil

    Marcio Eduardo Bergamini Vieira

Authors
  1. Esther Letícia Amorim Ribeiro
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  2. Tácio de Mendonça Lima
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  3. Marcio Eduardo Bergamini Vieira
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  4. Sílvia Storpirtis
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  5. Patricia Melo Aguiar
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Contributions

E.L.A.R. and P.M.A. planned the study. E.L.A.R. and T.M.L. performed the literature search and the qualitative analysis, supervised by P.M.A. E.L.A.R. wrote the first draft, and T.M.L., M.E.B.V., S.S., and P.M.A. reviewed the manuscript. All authors contributed to and have approved the final manuscript.

Corresponding author

Correspondence to Patricia Melo Aguiar.

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Conflict of interest

The authors have no potential conflicts of interest relevant to disclose. The research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Ribeiro, E.L.A., de Mendonça Lima, T., Vieira, M.E.B. et al. Efficacy and safety of aripiprazole for the treatment of schizophrenia: an overview of systematic reviews. Eur J Clin Pharmacol 74, 1215–1233 (2018). https://doi.org/10.1007/s00228-018-2498-1

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  • DOI: https://doi.org/10.1007/s00228-018-2498-1

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