Article

Aripiprazole in children and adolescents: clinical experience

Children's Specialized Hospital, Toms River, NJ 08755, USA.
Journal of Child Neurology (Impact Factor: 1.67). 08/2005; 20(7):603-10. DOI: 10.1177/08830738050200071301
Source: PubMed

ABSTRACT Despite few supportive data, aripiprazole was being administered to children and adolescents for management of mood instability, aggression, and psychosis. Using a retrospective review (n = 11) and prospective recruitment (n = 6), 17 children and adolescents received aripiprazole 5 to 20 mg/day. Only 4 of 16 bipolar and autistic subjects (25%) demonstrated reduced aggression without adverse events, and the symptoms of 2 of 4 psychotic subjects improved. Coadministration of sedative medications (particularly guanfacine or clonidine) and weight < 58 kg increased the risk of adverse events, such as increased lability and aggression. All three children < 8.6 years old, all four children < 34 kg, and all five children receiving alpha2-agonists developed adverse events prior to clinical efficacy. Age > 11 years, weight > 58 kg, and absence of sedative medications were associated with a 56% (five of nine) success rate. Until larger, prospective studies are completed, caution is advised when considering aripiprazole for smaller children and children receiving sedative medications.

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    • "In the United States, aripiprazole is used to treat various childhood and adolescent disorders, including Tourette syndrome, pervasive developmental disorder, conduct disorder, and pediatric bipolar disorder (Findling et al. 2003; Barzman et al. 2004; Stigler et al. 2004; Biederman et al. 2005; Murphy et al. 2005; Stachnik and Nunn-Thompson 2007). This increased usage is occurring even though D2-like partial agonists have seldom been examined using developmental animal models and results from a minority of human clinical studies suggest caution in prescribing aripiprazole to children (Rugino and Janvier 2005). Studies employing adult animal models have established that D2-like partial agonists exhibit low intrinsic activity (i.e., function as antagonists) at normosensitive DA presynaptic receptors. "
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