Aripiprazole prescribing patterns and side effects in elderly psychiatric inpatients.

OBJECTIVE: This analysis examined dosing patterns and safety of aripiprazole in elderly inpatients. METHODS: A total of 52 elderly inpatients treated with aripiprazole over 3 years were retrospectively identified to examine dosing patterns and side effects associated with use of aripiprazole. RESULTS: The most common psychiatric diagnoses in these patients were schizophrenia/schizoaffective disorder (29%), bipolar disorder (25%), and major depressive disorder (23%). The median starting and maximum daily doses were 5 mg and 10 mg, respectively. For patients whose dose was titrated upward during the hospitalization, the mean time to the first titration was 3.4 days and the mean time to achieve maximum dose was 5 days. Nine patients (17%) had documented side effects, with agitation/activation the most frequently reported effect (8%). Aripiprazole was continued after hospital discharge in 54% of patients, with most patients receiving 10 to 15 mg/day. CONCLUSION: Aripiprazole was generally well tolerated, with agitation/activation the most common side effect reported in elderly inpatients.

Predictors of aripiprazole treatment continuation in hospitalized patients.

OBJECTIVE: Aripiprazole is a second-generation antipsychotic that is increasingly prescribed in a variety of psychiatric disorders. The goal of this study was to investigate patient and treatment factors associated with aripiprazole treatment continuation on hospital discharge in psychiatric inpatients. METHOD: This was a retrospective cohort analysis of patients admitted to a psychiatric hospital between January 1, 2003, and June 30, 2006, and treated with aripiprazole. The goal was to determine factors associated with continuation of aripiprazole throughout the hospital stay and on discharge from the hospital. Covariates assessed included patient demographics, prior psychiatric hospitalizations, diagnoses, prior antipsychotic use, and concomitant psychotropic medications. Aripiprazole-specific covariates were starting and maximum dose and dose titration pattern. Diagnoses were identified using ICD-9-CM codes. RESULTS: There were 1957 aripiprazole-treated patients included in this study, and 1573 (80%) continued aripiprazole treatment at the time of hospital discharge. Median starting doses were lower (5 mg/day) for younger and older patients, and patients with psychotic disorders received higher doses than other patients. Approximately 58% of patients had at least 1 aripiprazole dose titration while hospitalized, and most (73%) of those patients had a dose titration within 3 days of admission. Predictors of treatment continuation in this broad patient population were younger age, a diagnosis of bipolar or major depressive disorder, higher maximum aripiprazole doses, and upward dose titration within 3 days of admission. Patients receiving concomitant anticholinergics or antipsychotics were less likely to continue treatment as were those receiving aripiprazole at the time of hospitalization. CONCLUSION: In this acute inpatient psychiatric setting, continuation of aripiprazole treatment on discharge was achieved in most patients. Demographic, diagnostic, and treatment factors predicting aripiprazole treatment effectiveness were identified.