Investigation into the long-term metabolic effects of aripiprazole adjunctive to
lithium, valproate, or lamotrigine.
Author(s): Kemp DE(1), De Hert M, Rahman Z, Fyans P, Eudicone JM, Marler SV, Baker RA,
Carlson BX.
Affiliation(s): Author information:
(1)University Hospitals Case Medical Center, Case Western Reserve University,
Cleveland, OH, USA. kemp.david@gmail.com
Publication date & source: 2013, J Affect Disord. , 148(1):84-91
BACKGROUND: Bipolar I disorder (BPD) patients are often overweight or obese, and
likely to have metabolic syndrome. Several medications used to treat BPD are
associated with increased body weight and/or worsening metabolic parameters.
METHODS: Metabolic data were analyzed from two efficacy studies of aripiprazole
plus the mood stabilizers, lithium/valproate (Study CN138-189), or lamotrigine
(Study CN138-392), in the long-term treatment (52 weeks) of BPD. Changes in body
weight, individual metabolic parameters, and incidence of metabolic syndrome were
assessed.
RESULTS: In the lithium/valproate study, modest increases in body weight were
observed at Week 52 in both groups: 1.7 ± 0.8 kg in the lithium/valproate group,
and 1.6 ± 0.7 kg in the adjunctive aripiprazole group; this difference was
nonsignificant. In the lamotrigine study, decreases in body weight were observed
at Week 52 with lamotrigine alone (-2.2 ± 1.0 kg), whereas a modest increase was
observed when combined with aripiprazole (0.4 ± 1.0 kg). In both studies, rates
of metabolic syndrome at 52 weeks did not increase from baseline with
aripiprazole, and median changes from baseline in individual metabolic syndrome
parameters were similar with both mood stabilizer monotherapy and the addition of
aripiprazole as an adjunctive therapy.
LIMITATIONS: This was a post-hoc analysis, and a low percentage of patients
completed the lamotrigine study.
CONCLUSIONS: Aripiprazole plus a mood stabilizer has minimal impact on metabolic
changes in predominantly overweight/obese BPD patients over a 52-week period. In
both studies, modest mean increases in weight with the addition of aripiprazole
were not accompanied by increased rates of metabolic syndrome or changes in
metabolic parameters.
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