title: Risk of Extrapyramidal Adverse Events With Aripiprazole.
abstract: Aripiprazole is a unique atypical antipsychotic with partial agonist activity on the dopamine-2 (D2) receptor. This unique pharmacological profile of aripiprazole was thought to lead to a lower incidence of extrapyramidal symptoms (EPSs). However, recent case reports have alluded to an increase in the risk of EPS in aripiprazole users compared with nonusers of the drug. No epidemiologic studies to date have quantified this risk. We conducted a pharmacoepidemiologic study composed of a nested case-control study using a large health claims database (IMS Health) in the United States. In the nested case-control analysis, there were 5242 cases of EPS with 50,532 corresponding controls in the entire cohort. The odds ratio (OR) for EPS among those with any prescription of aripiprazole was 5.38 (95% confidence interval [CI], 3.03-9.57). The OR was lower among those taking 2 to 3 prescriptions (OR, 2.9; 95% CI, 1.07-7.85) but increased in those receiving greater than 4 prescriptions (OR, 8.64; 95% CI, 2.63-28.38). All risk periods were compared with those of subjects who had not used aripiprazole or other antipsychotics. For the secondary outcome of dyskinesia, the risk for aripiprazole was 8.50 (95% CI, 8.53-2.27-31.97) compared with that of nonusers. In conclusion, we found an increase in the risk of EPS and dyskinesias among users of aripiprazole.
authors: From the *Department of Ophthalmology and Visual Sciences, University of British Columbia; †British Columbia Mental Health and Addictions Research Institute; ‡Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; §Department of Neurology, University of Washington, Seattle, WA; ∥Department of Pediatrics, Faculty of Medicine, and ¶Child & Family Research Institute, University of British Columbia; and #Pharmaceutical Outcomes Programme, British Columbia Children's Hospital, Vancouver, British Columbia, Canada.
authors: Mahyar
authors: M
authors: Etminan
authors: Ric M
authors: RM
authors: Procyshyn
authors: Ali
authors: A
authors: Samii
authors: Bruce C
authors: BC
authors: Carleton
mesh_terms: D000067575:Administrative Claims, Healthcare / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects*; D000068180:Aripiprazole / Q000009:adverse effects*; D001480:Basal Ganglia Diseases / Q000139:chemically induced* / Q000453:epidemiology; D016022:Case-Control Studies; D016208:Databases, Factual / Q000706:statistics & numerical data; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004409:Dyskinesia, Drug-Induced / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012306:Risk; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D000068180:Aripiprazole