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Int Clin Psychopharmacol. 2014 Mar;29(2):77-85. doi: 10.1097/YIC.0000000000000005.

The advantage of using 3-week data to predict response to aripiprazole at week 6 in first-episode psychosis.

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1
aDepartment of Psychiatry, Chonbuk National University Medical School bResearch Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, Jeonju cDr Cho's Neuropsychiatry Clinic and Research Center, Busan dDepartment of Psychiatry, Soonchunhyang University of College of Medicine, Seoul eGraduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon fDepartment of Psychiatry, Gil Medical Center, Gachon University, Incheon gDepartment of Psychiatry, Chonnam National University Medical School, Gwangju hDepartment of Psychiatry, Myongji Hospital, Kwandong University College of Medicine, Koyang iDepartment of Psychiatry, Inje University College of Medicine, Ilsan Paik Hospital, Goyang jDepartment of Psychiatry, Kyungpook National University School of Medicine, Daegu kSt. John of God Hospital, Kwangju lDepartment of Psychiatry, Kangwon National University College of Medicine, Chunchon mDepartment of Psychiatry, Wonkwang University, School of Medicine, Iksan, Republic of Korea.

Abstract

We investigated the efficacy and safety of aripiprazole in first-episode psychosis and explored the association between early response and later response to this medication. This was a 6-week, open-label, multicenter trial. The study population consisted of 59 patients with a DSM-IV diagnosis of a schizophreniform disorder, schizoaffective disorder, schizophrenia, or psychotic disorder not otherwise specified. The primary outcome measures were the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression-Severity scale. To assess the safety, we measured the drug-related adverse events, weight, and lipid-related variables. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated for the response status at weeks 2 and 3 to predict the subsequent response at week 6. Among the 59 participants, 38 were able to complete the 6-week trial. Treatment with aripiprazole resulted in significant improvement in the PANSS and Clinical Global Impression scores over time. The response rate (defined as a ≥30% decrease in the PANSS total score from baseline to the last observation) was 69.1%. The most accurate prediction of later response in terms of negative predictive value and specificity was a reduction in the PANSS total score from baseline to week 3 of at least 20%. Aripiprazole had a modest side effect burden and was characterized by a safe profile with respect to weight and metabolic side effects. These results indicate that aripiprazole is effective and safe in the treatment of first-episode psychosis. The response at week 3, rather than week 2, predicted the later response more accurately.

PMID:
23970176
DOI:
10.1097/YIC.0000000000000005
[Indexed for MEDLINE]
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