Proposed strategies for successful clinical management with aripiprazole

Background: Aripiprazole is an effective medication for treating patients with schizophrenia and bipolar disorder, and as an adjunct in patients with major depressive disorder and an inadequate response to antidepressant treatment, that is generally safe and well tolerated. Despite its potential clinical benefits, the management of aripiprazole-treated patients can be challenging due to the lack of a simple dosing strategy and guidelines for preventing and managing potential adverse effects. Objective: Two initiation/dosing strategies with aripiprazole are presented that are based on the overall symptom profile rather than specific clinical diagnosis: a rapid titration/high-close strategy and a slow titration/low-dose strategy. Methods: The dosing strategy recommendations are based on clinical experience and a PubMed database search conducted with no date restrictions for English-language literature. Keywords included aripiprazole, dose switching or strategy, schizophrenia or bipolar disorder and adverse effects. Conclusions: Two strategies have been designed to help clinicians tailor aripiprazole therapy to the specific needs of individual patients and manage common adverse effects that may be encountered during therapy.