Switching of antipsychotics to aripiprazole in the treatment of schizophrenia

Background: A sudden change in antipsychotics in the pharmacotherapy of schizophrenia might worsen the clinical condition or induce a relapse of psychotic symptoms. This study reports on shifting from other antipsychotics to aripiprazole during the course of treatment, with further analysis of factors related to a successful switch. Methods: An observational study was conducted. Study subjects included 45 patients with schizophrenia whose medication was changed from other antipsychotics to aripiprazole. The reasons for the change, course of illness, and types and dosage of antipsychotics previously used were collected. The clinical severity before and 12 weeks after switching or at termination were assessed using the Clinical Global Impression-Severity scale. Results: The majority (71.1%) of the study subjects changed antipsychotics because of adverse effects from previous medications. About 70% successfully completed the switch. Patients who had been taking second-generation antipsychotics (SGAs), had less clinically severe disease, or had a shorter course of illness were able to make a smoother transition to aripiprazole. Reported adverse events related to the transition were mild and infrequent. Conclusion: Not all antipsychotics can be successfully switched to aripiprazole, a novel antipsychotic. Apart from clinical factors, a successful change of antipsychotics also depends on the complexity and the pharmacological properties, as well as the duration of administration of previous antipsychotics.