Reasons for Aripiprazole Discontinuation in Schizophrenia – A Retrospective Review

Objectives: Patients with schizophrenia taking firstor second-generation antipsychotic drugs may switch to treatment with Aripiprazole due to side effects. This atypical antipsychotic launched in Europe in 2004, and has a better reported safety profile. However, patients also discontinue Aripiprazole, despite the lack of a comparable alternative antipsychotic. As very few data are available in the literature, it seems important to investigate the reasons for Aripiprazole discontinuation. Methods: A retrospective multicenter observational study of 287 patients with schizophrenia was conducted in France, Germany and Sweden. Eligible patients were treated with aripiprazole in the last two years and were switched to another antipsychotic. Their psychiatrists were asked to report online the reasons for discontinuation of aripiprazole and of previous antipsychotic treatments. Results: Considering the whole sample, reasons for aripiprazole discontinuation were poor efficacy with respect to positive (44%) and negative (31%) symptoms and intolerable side effects (27%). No significant difference was found between antipsychotic-naïve patients and the rest. These reasons were given for 40%, 25% and 52% of patients, respectively, for discontinuation of previous antipsychotic treatments. Conclusion: Aripiprazole seems to be prescribed mainly after intolerable side effects are observed with other therapies. Aripiprazole was discontinued due to lack of efficacy for positive and negative symptoms at rates greater than those for intolerable side effects.