Ultra-High-Dose Long-Acting Injectable Aripiprazole in Chronic Refractory Schizophrenia: A Case Report
Lucie Bartova, Markus Dold, Nicole Praschak-Rieder, Angela Naderi-Heiden and Siegfried Kasper*
Division of Biological Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
- *Corresponding Author:
- Siegfried Kasper
Division of Biological Psychiatry
Department of Psychiatry and Psychotherapy
Medical University of Vienna
Waehringer Guertel 18-20
A-1090 Vienna, Austria
Tel: +43(0)1 40400-35680
Fax: +43(0)1 40400-30990
E-mail: [email protected]
Received date: August 19, 2015; Accepted date: October 21, 2015; Published date: October 28, 2015
Citation: Bartova L, Dold M, Rieder NP, Heiden AN, Kasper S (2015) Ultra-High-Dose Long-Acting Injectable Aripiprazole in Chronic Refractory Schizophrenia: A Case Report. J Clin Toxicol 5:270. doi:10.4172/2161-0495.1000270
Copyright: © 2015 Bartova L, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
An intramuscular long-acting injectable (LAI) aripiprazole administered once a month as a single injection into the gluteal muscle is increasingly appreciated in the course of a long-term maintenance treatment of schizophrenia. Due to efficacy in delaying and decreasing relapse, low rates of feared side effects including extrapyramidal, metabolic and cardiovascular disturbances, aripiprazole LAI has the potential to significantly improve adherence. According to the prescribing information, the maximal starting as well as maintenance dose of aripiprazole LAI is restricted to 400 mg following a 26-day interval between the single doses.
We present a case of a 72-year-old female inpatient with an acute exacerbation of chronic refractory schizophrenia treated with aripiprazole LAI (ABILIFY MAINTENA) beyond the officially approved dose range (up to 1200 mg per month). Applying this ultra-high-dose antipsychotic maintenance treatment over 12 weeks, we observed a clinically meaningful reduction of the initially severe psychopathological phenomena with primarily positive symptoms (a total-score reduction from 111 to 75 on the Positive and Negative Syndrome Scale; PANSS). Despite multi-morbidity and rather advanced age of the patient, no objectifiable adverse events, which were measured by The Dosage Record Treatment Emergent Symptom Scale (DOTES) and The Barnes Akathisia Rating Scale (BARS), occurred during the treatment.
Our safe experience with an almost threefold higher monthly dose might encourage researchers to further investigate the efficacy, tolerability as