Long Acting Injectable Aripiprazole in the treatment of psychotic subjects comorbid with alcohol and substance use disorders: an open label observational study

Giovanni Martinotti 1, 2 ; Chiara Montemitro 1 ; Mauro Pettorruso 3 ; Marco Di Nicola 3 ; Chiara Vannini 1 ; Gaia Baroni 1 ; Beatrice Tittozzi 3 ; Veronica Cantelmi 3 ; Marco Alessandrini 4 ; Giuseppe Ducci 5 ; Massimo di Giannantonio 1,4

1 Department of Neuroscience and Imaging, Institute of Psychiatry, “G. D’Annunzio” University of Chieti, Chieti, Italy

2 Department of Human Sciences, University LUMSA of Rome, Rome, Italy

3 Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario “A. Gemelli”, Università Cattolica del Sacro Cuore, Rome, Italy

4 Department of Mental Health, ASL Abruzzo 2, Chieti, Italy 5 Department of Mental Health, ASL Roma 1, Rome, Italy

Abstract

Background: Among patients affected by a severe mental illness, comorbid addictive disorders are very common, despite they are under diagnosed and poorly treated. Dual-diagnosis patients are usually difficult to treat and they show a very low level of compliance. Oral formulation of Aripiprazole has shown to be efficacious in reducing craving and preventing relapses in subjects with alcohol use disorders and other forms of addiction. Our aim was to explore the effectiveness of Aripiprazole Long-Acting Injection in dual-diagnosis patients presenting with psychotic symptoms.

Methods: In this observational, non-interventional study, we collected clinical and demographic data of outpatients presenting with psychotic symptoms comorbid with addictive disorder and receiving aripiprazole long acting monthly injection. Data about Timeline Follow-Back, Global Assessment of Functioning (GAF) and Brief Psychiatric Rating Scale (BPRS), performed before treatment initiation, during treatment and after treatment discontinuation, have been collected.

Results: 18 patients completed the study (Table 1). At T0, BPRS and GAF scores were respectively 60.86 ± 12.11 and 44.38 ± 12.93. At T1, BPRS and GAF scores were respectively 48.57 ± 11.90 and 55.31 ± 13.43. Reduction in BPRS scores and improvement in GAF scores after treatment were statically significant (P<0.001). Twelve (66.7%) patients quit assuming substances during treatment. No pathological prolongation of QTc rates was observed. Conclusions: Our preliminary results suggest that aripiprazole long-acting intramuscular formulation may represent a valid opportunity for psychotic symptoms comorbid with Substance-related and Addictive Disorder. The mechanism of action of the drug, its pharmacokinetic properties, and the improvements in compliance might explain its potentialities in dual-disorders.

KEY WORDS: aripiprazole, LAI, psychosis, dual diagnosis, addiction

Martinotti et al., RAP Journal

 

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