title: Switching to aripiprazole in subjects with pervasive developmental disorders showing tolerability issues with risperidone.
abstract: BACKGROUND
  Subjects with Pervasive Developmental Disorders (PDD) often exhibit behavioral symptoms such as aggressiveness and irritability, which are targets of psychopharmacologic intervention. This retrospective study was designed to examine children and adolescents with PDD experiencing tolerability issues with risperidone treatment, and thereby assess the efficacy and tolerability of switching to aripiprazole.
  
  
  METHODS
  This naturalistic study included 23 subjects with PDD (16 males, 7 females, age range 9-24 years, mean age 15.1±3.9 years) diagnosed according to DSM-IV criteria and followed up for 14.9±8.4 weeks after switching to aripiprazole from risperidone. Outcome measures were the Clinical Global Impression-Severity (CGI-S) and CGI Improvement (CGI-I) scales.
  
  
  RESULTS
  The mean CGI-S scores of pre-aripiprazole treatment and post-aripiprazole treatment were, respectively 4.7±1.4 and 4.6±1.3. Mean maintenance dosages of risperidone and aripiprazole were, respectively, 0.7±0.5mg/day and 2.8±1.3mg/day. The mean CGI-I score, which shows the difference induced by switching from risperidone to aripiprazole, was 3.4±0.8 for the whole sample, suggesting that the efficacy of risperidone for treating behavioral problems of PDD was maintained by aripiprazole. Some improvement of safety/tolerability issues such as increased appetite, somnolence, hyperprolactinemia, and amenorrhea occurred after switching to aripiprazole.
  
  
  CONCLUSIONS
  Results show that switching to aripiprazole might be generally well tolerated and might constitute an alternative treatment for subjects with PDD who experience tolerability issues with risperidone treatment. Additional long-term controlled studies of PDD subjects should be undertaken to evaluate the efficacy and safety of switching to aripiprazole from other antipsychotics.
authors.affiliation: Department of Neuropsychiatry, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-Cho, Yoshida-Gun, Fukui 910-1193, Japan. mak1977019@yahoo.co.jp
authors.forename: Makoto
authors.initials: M
authors.lastname: Ishitobi
authors.forename: Michio
authors.initials: M
authors.lastname: Hiratani
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Kosaka
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Takahashi
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Mizuno
authors.forename: Mizuki
authors.initials: M
authors.lastname: Asano
authors.forename: Tetsuhito
authors.initials: T
authors.lastname: Murata
authors.forename: Akemi
authors.initials: A
authors.lastname: Tomoda
authors.forename: Yuji
authors.initials: Y
authors.lastname: Wada
mesh_terms: D000293:Adolescent; D000068180:Aripiprazole; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology*; D057915:Drug Substitution; D005260:Female; D006801:Humans; D008297:Male; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use*; D015363:Quinolones / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D018967:Risperidone / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D010879:Piperazines; D015363:Quinolones; D000068180:Aripiprazole; D018967:Risperidone