A UK panel consensus on the initiation of aripiprazole for the treatment of bipolar mania.
OBJECTIVE
The objective of this consensus paper is to provide practical guidance on why and how aripiprazole, with its distinct pharmacological and side effect profile, should be used for treatment of acute bipolar mania.


METHODS
An advisory panel of UK healthcare professionals, with extensive experience of prescribing aripiprazole for acute bipolar mania, met to discuss its use in this setting.


RESULTS
The panel agreed that aripiprazole is effective in treating bipolar mania when prescribed and dosed appropriately, in both the short and long term, as monotherapy or in combination with a mood stabilizer. Unlike other atypical agents, aripiprazole has antimanic effects that are not associated with sedation, which is beneficial for patients, particularly in the long term. If rapid tranquillization is required when initiating aripiprazole in acutely disturbed patients, short-term coprescription of a benzodiazepine is recommended. Most side effects associated with aripiprazole occur within the first 1-3 weeks and are usually transient and easily treatable. Aripiprazole poses low risk of metabolic side effects, sexual dysfunction, and anhedonia, which can facilitate treatment adherence and help improve clinical outcomes.


CONCLUSIONS
Aripiprazole is an effective first-line treatment for acute bipolar mania with a favorable safety/tolerability profile.
Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK. Luiz.Dratcu@slam.nhs.uk
Luiz
L
Dratcu
Sotonte
S
Bobmanuel
Wendy
W
Davies
Alan
A
Farmer
Mohan
M
George
Tanvir
T
Rana
Mala
M
Singh
Martin
M
Turner
D000208:Acute Disease; D059445:Anhedonia / Q000187:drug effects; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000068180:Aripiprazole; D001714:Bipolar Disorder / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D006801:Humans; D008134:Long-Term Care; D008659:Metabolic Diseases / Q000139:chemically induced / Q000517:prevention & control; D010358:Patient Participation; D010879:Piperazines / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D011595:Psychomotor Agitation / Q000517:prevention & control; D015363:Quinolones / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced / Q000517:prevention & control; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D010879:Piperazines; D015363:Quinolones; D000068180:Aripiprazole