Effectiveness and tolerability of aripiprazole in a real-world outpatient population of youth [Günlük uygulamada ayaktan tedavi gören bir ergen hasta popülasyonunda aripiprazolün etkinlik ve tolerabilitesi]

Objectives: To identify the pattern of initiation for offlabel use of aripiprazole among adolescent outpatients; determine whether or not aripiprazole is effective and tolerable for the treatment of adolescents with a wide range of psychiatric symptoms and disorders or not. Methods: Medical charts were retrospectively reviewed for the effectiveness and tolerability of aripiprazole. The Clinical Global Impression Scale (CGI), the Brief Symptom Inventory (BSI), and the Extrapyramidal Symptom Rating Scale were used. Results: The data were available on 31 patients. The sample consisted of mostly females (87.1%). The mean age was 16.38±1.14 years, and the ages range was 15-19 years. Twenty-one patients (67.8%) had at least one comorbid disorder. The most common comorbid disorder was major depressive disorder. The mean initial dosage of aripiprazole was 4.83±3.59 mg (2.50 mg - 20.00 mg), and the mean endpoint dosage was 8.62±3.46 mg (2.50 mg - 15.00 mg). The mean duration of aripiprazole medication was 19.56±1.23 months (range: 4-48 months). Endpoint CGI-S scores were significantly lower compared with baseline CGI-S score (p<0.001). Similarly, the difference between depression severity (z=-3.232; p=0.001), anxiety severity (z=-3.004; p=0.003), hostility severity (z=-3.207; p=0.001), psychoticism severity (z=-1.973; p=0.049), and paranoid ideation severity (z=2.733; p=0.006) scores were statistically significant. The difference between the baseline and endpoint BSI Global Indices of distress scores were found to be statistically significant (The Global Severity Index: z=-2.987; p=0.003, the Positive Symptom Distress Index: z=-3.435; p=0.001, and the Positive Symptom Total: z=-3.023; p=0.003). Six cases (20.0%) discontinued the treatment. The most frequent adverse effects were asthenia (50.0%), somnolence (42.9%), and dizziness (39.30%). The most severe extrapyramidal symptoms were: impression of slowness or weakness, difficulty in carrying out routine tasks (11.5%), and tonic muscular contractions localized to one or several muscle groups, particularly in the throat, neck or back (11.5%). None of the cases had abnormal involuntary movements (dyskinesia) of the extremities or trunk. Conclusion: Aripiprazole was well tolerated and effective in our clinical practice and appears to be a safe and efficacious alternative in adolescents. However, a prospective clinical trial with a randomized controlled design is warranted

A new challenge for child psychiatrists: Inpatient care management during coronavirus pandemic

[No abstract available