title: Aripiprazole and Risperidone for Treatment of Methamphetamine-Associated Psychosis in Chinese Patients.
abstract: We evaluated tolerability and efficacy of aripiprazole and risperidone for treatment of methamphetamine (METH) associated psychotic symptoms in China. Patients with acute METH-associated psychotic symptoms (N=42) and with Positive and Negative Syndrome Scale (PANSS) total score between 60 and 120 were randomized to aripiprazole (initial dose 5-10mg per day followed by flexible doses 5-15 mg per day) or risperidone (initial dose 2-4 mg per day followed by flexible doses 4-6 mg per day) from day 3 to 25 of inpatient hospital stay. Outcome measures included PANSS and Clinical Global Impressions-Severity of Illness scale (CGI-S), METH craving Visual Analogue Scale (VAS), Simpson Angus Scale (SAS), Barnes Assessments Akathasia Rating Scale (BARS), and self-reported adverse effects evaluated during treatment. Retention was evaluated using Kaplan-Meier survival analysis and the MIXED models procedure was used to compare the groups on measures of psychotic and extra-pyramidal symptoms. Patients in both aripiprazole and risperidone groups showed statistically significant reductions in psychotic symptomatology from baseline during treatment (p<0.001) with no statistically significant differences between the treatment groups (p=0.73 and p=0.15, respectively). Risperidone-treated patients reported significantly greater METH craving reductions (p<0.001). Overall, 71% of patients completed the entire study, but the aripiprazole group had a significantly lower retention than the risperidone group (p=0.007), primarily due to medication related adverse effects. Aripiprazole-treated patients also had significantly more akathisia (p=0.03) and agitation (p=0.02) than risperidone-treated patients. Patients in both groups who tolerated their medications and completed the entire study achieved comparable reductions of psychotic symptoms.
authors.affiliation: Mental Health Center, The Second Xiangya Hospital, The Central South University, 139 Renmin Road, Changsha 410011, Hunan, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.affiliation: Drug Abuse Ward, Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, 70 Youyi Road, Wuhan 430022, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Drug Abuse Ward, Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, 70 Youyi Road, Wuhan 430022, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Drug Abuse Ward, Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, 70 Youyi Road, Wuhan 430022, China.
authors.forename: Huijing
authors.initials: H
authors.lastname: Chen
authors.affiliation: Drug Abuse Ward, Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, 70 Youyi Road, Wuhan 430022, China.
authors.forename: Zaifeng
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Yale School of Medicine, Department of Psychiatry, 34 Park Street, New Haven, CT 06519, USA.
authors.forename: Richard S
authors.initials: RS
authors.lastname: Schottenfeld
authors.affiliation: Mental Health Center, The Second Xiangya Hospital, The Central South University, 139 Renmin Road, Changsha 410011, Hunan, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Hao
authors.affiliation: Drug Abuse Ward, Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, 70 Youyi Road, Wuhan 430022, China.
authors.forename: Marek Cezary
authors.initials: MC
authors.lastname: Chawarski
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000068180:Aripiprazole / Q000009:adverse effects / Q000627:therapeutic use*; D002681:China; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011605:Psychoses, Substance-Induced / Q000188:drug therapy*; D018967:Risperidone / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D000068180:Aripiprazole; D018967:Risperidone
keywords: Aripiprazole; Efficacy; Methamphetamine-associated psychosis; Risperidone; Safety; Tolerability