Aripiprazole-Induced Hyperlipidemia: An Update.
OBJECTIVE
To review the literature on the metabolic side effects of aripiprazole. Three cases of aripiprazole-induced hypertriglyceridemia are also presented.


METHODS
A search was conducted of English-language articles and abstracts (meta-analyses, randomized controlled trials, clinical trials, naturalistic open-label trials, reviews, and case reports) published up to August 31, 2014, in electronic databases (PubMed, MEDLINE).


METHODS
Free-text and MeSH search keywords included aripiprazole, cholesterol, triglyceride, lipid profile, hyperlipidemia, and hypercholesterolemia and their differing terminations and combinations. The search was supplemented by a manual review of reference lists from the identified publications. Pediatric studies were excluded.


METHODS
Twenty-two articles were found and 3 aspects of the metabolic side effects of aripiprazole were reviewed: (1) the prevalence of the metabolic syndrome in mentally ill patients prior to any antipsychotic use to highlight the initial predisposition of this group of patients to develop the metabolic syndrome, (2) the prevalence of metabolic changes depending on the choice of antipsychotic (aripiprazole compared to other antipsychotics), and (3) metabolic changes reported after switching from an antipsychotic to aripiprazole.


RESULTS
Patients with mental disorders are at high risk for developing dyslipidemia, diabetes, and the full criteria of the metabolic syndrome. Antipsychotic use exacerbates this risk, thus increasing the mortality in this population. Nevertheless, it seems that the risk for these side effects varies with each antipsychotic. Although by and large the literature supports the supposition that aripiprazole causes less metabolic effects than other antipsychotics, we report 3 cases of serious aripiprazole-related dyslipidemia in young subjects.


CONCLUSIONS
On the basis of these 3 cases, aripiprazole can cause hypertriglyceridemia. Triglyceride levels should be carefully monitored in patients with mental disorders taking aripiprazole.
Department of Psychiatry, Lebanese University, Beirut 961, Lebanon. carolinetarraf@gmail.com.|Department of Psychiatry, Lebanese University, Beirut, Lebanon.
Caroline
C
Tarraf
Department of Psychiatry, Lebanese University, Beirut, Lebanon.
Wadih J
WJ
Naja
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects*; D000068180:Aripiprazole / Q000009:adverse effects*; D001714:Bipolar Disorder / Q000188:drug therapy; D002784:Cholesterol / Q000378:metabolism; D006801:Humans; D006949:Hyperlipidemias / Q000139:chemically induced* / Q000378:metabolism*; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy; D014280:Triglycerides / Q000378:metabolism
D014150:Antipsychotic Agents; D014280:Triglycerides; D000068180:Aripiprazole; D002784:Cholesterol