aripiprazole / Generic mfg. - LARVOL DELTA

Cost-Effectiveness Analysis of Xanomeline and Trospium Chloride for Schizophrenia in the United States (ISPOR 2025) - "In this cost-effectiveness analysis, we aimed to evaluate the cost-effectiveness of xanomeline and trospium chloride compared to aripiprazole, an atypical antipsychotic. Our findings suggest that xanomeline and trospium chloride is not cost-effective as maintenance treatment for schizophrenia in the U.S. We found that xanomeline and trospium chloride would be cost-effective at $150,000/QALY if the total healthcare costs for a three-month cycle did not exceed $5,950."

Cost effectiveness • HEOR • CNS Disorders • Mental Retardation • Metabolic Disorders • Psychiatry • Schizophrenia

Comparative Efficacy, Safety, and Tolerability of Xanomeline and Trospium Chloride versus Eight Atypical Antipsychotics for the Acute Treatment of Adults with Schizophrenia - A Network Meta-Analysis (ISPOR 2025) - " Xanomeline/trospium treatment significantly improved odds of clinical response versus aripiprazole (odds ratio [OR]: 1.85; 95% credible interval [CrI]: 1.11, 3.11), brexipiprazole (OR: 2.23; 95% CrI: 1.34, 3.83), and cariprazine (OR: 2.05; 95% CrI: 1.19, 3.57), increased odds of all-cause discontinuation versus all comparators except cariprazine, and reduced odds of clinically significant weight gain versus aripiprazole, brexipiprazole, cariprazine, lumateperone, olanzapine, quetiapine, and risperidone. Xanomeline/trospium demonstrated improved clinical response and reduced weight gain compared with several existing oral antipsychotics."

Retrospective data • Anesthesia • CNS Disorders • Psychiatry • Schizophrenia

D2 receptor activation modulates NMDA receptor antagonist-enhanced high-frequency oscillations in the olfactory bulb of freely moving rats. (PubMed, Psychopharmacology (Berl)) - "These results suggest that NMDA receptor antagonist-enhanced HFO in the OB is generated predominantly independently of DA influence, however exogenous stimulation of D2R can modulate this rhythm. A second, but not third generation antipsychotic reduced HFO frequency."

Journal • Preclinical • CNS Disorders • Depression • Psychiatry

Exploring New Frontiers in Pharmacological Treatment of Depression: A Review on Recent Advances. (PubMed, Curr Med Chem) - "It appears promising to switch to monotherapy using new multifunctional antidepressants and add new atypical antipsychotics, such as brexpiprazole and aripiprazole. These include targeting receptors, such as N-methyl-D-aspartate and metabotropic glutamate receptors, and employing glutamatergic modulators and various augmentation strategies, all of which hold the potential for reversal of depressant effects. Combining innovative concepts with enhancements of existing discoveries may propel antidepressant research forward, offering hope for developing compounds that are effective and rapid in their action, even among patients who have found limited success with other therapies."

Journal • CNS Disorders • Depression • Major Depressive Disorder • Mental Retardation • Mood Disorders • Psychiatry

Aripiprazole as an Inhibitor of the EGFR/PI3K/AKT Signaling Pathway and Sensitizer of MPA Suppressed Progestin-Resistant Endometrial Cancer Cells. (PubMed, Arch Pharm (Weinheim)) - "Furthermore, APZ significantly enhanced the proliferation inhibitory effect of medroxyprogesterone acetate (MPA) against progestin-resistant KLE cells, displaying remarkable synergistic activity. These findings position APZ as a promising therapeutic candidate for EC, with potential utility both as a monotherapy and in combination with MPA, offering new avenues for EC treatment strategies."

Journal • CNS Disorders • Endometrial Cancer • Oncology • Solid Tumor • EGFR

The Synergistic Effect of High-Frequency Rtms With Atypical Antipsychotics on the Alleviation of Negative Symptoms of Schizophrenia (APA 2025) - "A further comparison of SANS scores between the medications used showed that paliperidone and cariprazine were similarly efficacious, both being better than aripiprazole and lurasidone (p<0.001). Conclusions Significant reduction of SANS total score and specifically in the avolition (22%) and alogia (19%) domains. It is noteworthy that individuals who were using paliperidone and cariprazine showed significantly better outcomes in terms of negative symptom reduction."

CNS Disorders • Psychiatry • Schizophrenia

A Review of the Literature on Case Reports Describing Post-Stroke Psychosis Treatment (APA 2025) - "All 9 patients were treated with antipsychotics, with olanzapine used in 5 cases, risperidone in 3 cases, aripiprazole in 2 cases, quetiapine in 1 case, amisulpride in 1 case, and clozapine in 1 case. Prior studies show that right hemispheric lesions, history of mental health problems, and pre-existing subcortical atrophy may be risk factors for post-stroke psychosis. This literature review included cases with right-sided or bilateral lesions. The majority of cases included patients without past psychiatric histories, which is not consistent with the literature but was based on a small sample size."

Case report • Clinical • Review • Cardiovascular • CNS Disorders • Psychiatry

Rabbit Syndrome: A Rare Iatrogenic Tremor Due to Discontinuation of Aripiprazole (APA 2025) - "Patient was initially managed with Effexor and Buspar for anxiety before switching to Lexapro and Abilify in 2020...Patient's Abilify was initially reduced to 5mg daily, Requip 1mg nightly for RLS and Concerta 54mg daily for ADHD...Management includes tapering off antipsychotics, switching medications, or using anticholinergics like Benztropine or Trihexiphenidyl. ß-blockers may also provide relief. Further research is necessary to better understand and treat Rabbit syndrome."

Preclinical • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Depression • Infectious Disease • Mood Disorders • Movement Disorders • Psychiatry • DRD2

Psychiatric Service Use in Patients With Serious Mental Illness and Substance Use Disorders: Aripiprazole Versus Paliperidone LAIs (APA 2025) - "This correlation may suggest several reasons for this increased rate: AL may be utilized in patients with high acuity illness, resulting in increased ED utilization; AL may result in patients having increased insight or help-seeking behavior; lastly, this may suggest that AL is simply not as effective at preventing decompensation in this patient population though still preventative for rehospitalization. Overall, the findings of our study and the impact of LAI choice on subsequent use of ED service suggests that further investigation is warranted to determine the most efficacious LAI (or combination of treatments) recommended in this patient population and further improve treatment of comorbid SMI and SUD."

Clinical • CNS Disorders • Psychiatry • Schizophrenia

Back to the Future: A Literature Review of Loxapine for Treatment Resistant Psychosis (APA 2025) - "The following search terms were used: "Loxapine after Clozapine", "Clozapine Resistance Loxapine", "Loxapine Clozapine Failure", "Loxapine Augmentation Clozapine", "Loxapine Olanzapine", and "Loxapine Augmentation... From review of the literature, there were 2 case reports of Loxapine initiation after failure of Clozapine, 6 articles regarding augmentation of Clozapine with Loxapine, 4 articles involving Loxapine initiation after failure of others antipsychotic (including Aripiprazole and Risperidone), and 5 literature reviews of multiple clinical scenarios in which Loxapine was utilized. In this search, there were 20 articles involving use of Loxapine inhaled powder or ingested liquid for agitation which were found incidentally... Further research is needed to measure the utilization of Loxapine after failure of Clozapine or other antipsychotics. Our review suggests that a trial of Loxapine may be indicated in cases..."

Review • Bipolar Disorder • Cardiovascular • CNS Disorders • Inflammation • Psychiatry • Schizophrenia

Highlighting Notable Antipsychotic Side Effects Impacting Lifestyle: And Their Management – Three Case Studies (APA 2025) - "The first of three cases relates to substantial weight gain and fatigue from risperidone, resulting in transition to aripiprazole with subsequent improvement in weight, however resulted in a crippling gambling addiction, which did not respond to dose adjustment, and resolved after transition from aripiprazole to lurasidone. All of these side effects can result in severe impairment on top of existing functional impact, and may be overlooked for a myriad of factors, including on the behalf of the patient, provider, and societal pressures. Literature review performed for these side effects is notable for proposed mechanisms, case reports, and management recommendations."

Adverse events • Case study • Clinical • CNS Disorders • Fatigue • Pain • Psychiatry • Pulmonary Disease • Schizophrenia

Heads Up: A Potential Interplay Between Antipsychotic Medications Sickle Cell Trait and Priapism (APA 2025) - "He experienced priapism with aripiprazole, risperidone, paliperidone, olanzapine, and lurasidone. Despite switching to cariprazine, which has lower alpha-1 adrenergic antagonism, episodes of priapism persisted. The patient achieved partial psychiatric stabilization with a low dose of pimozide and valproate, and sildenafil was added as a preventive measure for priapism, resulting in no further episodes. Pimavanserin was not pursued due to its cost... Clinicians should be aware of this potential side effect and educate patients on the importance of reporting symptoms and seeking timely medical care. Further research is needed to clarify the mechanisms of priapism related to antipsychotic use, develop treatment protocols for managing psychosis in cases of recurrent priapism, and explore the relationship between sickle cell trait and antipsychotic-induced priapism."

Cardiovascular • CNS Disorders • Genetic Disorders • Hematological Disorders • Psychiatry • Schizophrenia • Sickle Cell Disease

Risk of Mortality and Diabetic Ketoacidosis Following Initiation of Antipsychotics in Diabetic Psychiatric Patients: A Large-Scale Cohort Study (APA 2025) - "The intervention cohort (SGA use) included patients who initiated treatment with clozapine, olanzapine, or quetiapine after having an established diagnosis of diabetes, and was compared against a control cohort of patients with no history of taking the following antipsychotics: clozapine, olanzapine, quetiapine, risperidone, aripiprazole, ziprasidone, haloperidol. The initiation of clozapine, olanzapine, or quetiapine in patients with preexisting diabetes and mood or psychotic disorders is associated with an increased risk of mortality, DKA , and healthcare utilization when compared with diabetic patients with comorbid psychiatric illness without these SGA exposures. These findings underscore the importance of close monitoring and tailored management of patients starting an antipsychotic to mitigate the risk of death, DKA, and other complications."

Clinical • CNS Disorders • Diabetes • Mental Retardation • Metabolic Disorders • Psychiatry

4 Year Clinical Audit of a Clinic Providing Services for the Treatment of Early Psychoses (STEP) Utilizing Coordinated Specialty Care (CSC) (APA 2025) - "Over half (50.6%) were prescribed Risperidone/Paliperidone as their entry antipsychotic medication followed by Aripiprazole (21.7%), but at exit 30.1% were prescribed Aripiprazole and 34.9% Risperidone/Paliperidone. On average, CSC patients engaged with STEP for over 2.5 years, and 88% had medications optimized to monotherapy antipsychotic medication with significant improvements in positive symptoms and global and social recovery outcomes. Nonetheless, a significant increase in body weight calls for attention to manage this clinical concern more assertively. Use of the core assessment battery (CAB) undertaken in CSC clinics can provide front-line clinicians with pragmatic measurement-based information on which to undertake shared decision-making steps to bring about positive outcomes for persons with FEP."

Clinical • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Psychiatry • Schizophrenia

Quantitative Integration of Risks and Benefits of Three Treatment Strategies for Treatment Resistant Depression (APA 2025) - "The VAST-D and OPTIMUM trials compared three strategies in TRD: adding aripiprazole (A-ARI), adding bupropion (A-BUP), and switching to bupropion (S-BUP). These results suggest that the greater efficacy of A-ARI in TRD over S-BUP may not be worth its metabolic risks in patients who already have metabolic risk factors. The greater efficacy of A-BUP over S-BUP may not justify its risk of increased falls in frail patients. These conclusions depend on model parameters, about which there is significant uncertainty."

CNS Disorders • Depression • Mood Disorders • Movement Disorders • Obesity • Psychiatry

Treatment-Resistant Psychosis Secondary to Primary Hyperparathyroidism With Improved Psychiatric Symptoms After Parathyroidectomy (APA 2025) - "Patient had a long history of treatment resistant psychosis, and has been on trials of Fluphenazine, Clozapine, Valproic acid, Ziprasidone, Risperidone and Aripiprazole...Patient was restarted on Haloperidol, however symptoms did not improve with titration up to 30 mg per day... This case underscores the notable association between primary hyperparathyroidism (PHPT) and neuropsychiatric symptoms. The successful resolution of psychotic symptoms following parathyroidectomy strengthens the hypothesis of an association between hypercalcemia and psychiatric manifestations. Despite the frequent occurrence of these symptoms in PHPT patients, they are often underdiagnosed."

Bipolar Disorder • CNS Disorders • Endocrine Cancer • Endocrine Disorders • Metabolic Disorders • Oncology • Psychiatry • Schizophrenia • Solid Tumor

The Great Imitator: A Superimposed Neurosyphilis Infection in the Context of Newly Diagnosed HIV Encephalitis Presenting With Psychotic Symptoms (APA 2025) - "The patient was admitted to behavioral unit, initially treated with Abilify...Despite some hesitation by the ID team regarding antiretroviral therapy initiation due to the patient's possible lack of compliance & outpatient follow-up, Biktarvy was started... Ultimately, this case of neurosyphilis that went initially undetected in a patient with atypical psychotic features underscores the importance of early recognition and treatment of STDs. In addition to ensuring treatment for patients in a timely manner, thorough history taking should be done to avoid HIV spreading and prevention of opportunistic infections."

Alzheimer's Disease • Bipolar Disorder • CNS Disorders • Cognitive Disorders • Human Immunodeficiency Virus • Infectious Disease • Mental Retardation • Mood Disorders • Novel Coronavirus Disease • Psychiatry • Psychomotor Agitation • Ventriculomegaly • CD4

Unseen Threats: The Impact of Environmental Mycotoxin Exposure on Psychosis and Psychiatric Disorders in a New Jersey Cohort (APA 2025) - "Discharge medications included aripiprazole (20%), lithium (20%), olanzapine (20%), lurasidone (20%), clozapine (20%), haloperidol (20%), gabapentin (10%), divalproex (10%), oxcarbazepine (10%), clonazepam (10%), mirtazapine (10%), and quetiapine (10%)... This study highlights a potential link between environmental mold exposure and psychiatric presentations, with psychotic symptoms observed in 56% of patients. While causation cannot be inferred, the findings underscore the possible role of environmental factors in etiology or exacerbation of psychiatric conditions. This study contributes to a growing body of evidence that expands upon traditional views of psychiatric illness by incorporating environmental factors into the diagnostic framework."

Alzheimer's Disease • Bipolar Disorder • CNS Disorders • Cognitive Disorders • Depression • Mental Retardation • Mood Disorders • Psychiatry • Schizophrenia

Identification and Management of Hyperprolactinaemia in Patients With Intellectual Disabilities Who Are Prescribed Antipsychotic Medication (APA 2025) - "Of the 10 different antipsychotics prescribed, the most common were risperidone (50.7%) and olanzapine (30.7%)...Two patients were prescribed aripiprazole 2.5mg as an adjunct... A key area identified is how to increase uptake of blood tests in this patient group. Closer liaison with GP surgeries and proactive discussions with patients about the importance of screening for hyperprolactinaemia may help to improve outcomes. Referral to our in-house needle desensitisation service may also be helpful."

Clinical • CNS Disorders • Developmental Disorders • Mental Retardation • Musculoskeletal Diseases • Orthopedics • Osteoporosis • Psychiatry • Rheumatology • PRL

The Effects of Antidepressants on the Gut Microbiome: An Implication for a Perpetual Cycle of Depression and a Call for Nutritional Intervention? (APA 2025) - "The search terms included "gut microbiome" and "antidepressants" or "ketamine." Articles were selected based on predefined inclusion criteria, focusing on studies that investigated the impact of antidepressants on gut microbiota using human subjects, human cell lines, or animal models...Studies showed that SSRIs like fluoxetine and paroxetine reduced the abundance of gut bacteria such as Bacteroides and Firmicutes, while increasing others like Prevotella and Ruminococcus...Venlafaxine and amitriptyline were found to decrease beneficial gut bacteria such as Lactobacillus and increase inflammatory bacteria, potentially contributing to gut dysbiosis and depressive symptoms. Atypical antidepressants and MAOIs, such as aripiprazole and phenelzine, demonstrated potent antimicrobial effects... The review highlights a critical issue: antidepressants may not fully exhibit their therapeutic effects due to their negative impact on the gut microbiome,..."

CNS Disorders • Depression • Inflammation • Inflammatory Bowel Disease • Mental Retardation • Mood Disorders • Psychiatry

Navigating the Labyrinth: Rapid Cycling Bipolar Disorder With Comorbid ADHD and Substance Use Disorder (APA 2025) - "Initially hyperverbal and anxious, she was redirectable but admitted to noncompliance with her medications, including Adderall and Abilify...Due to persistent hyperverbal speech and decreased sleep, Abilify was switched to Seroquel, titrated to 200 mg at bedtime...This case underscores the importance of a tailored treatment approach when addressing rapid-cycling bipolar disorder with comorbid conditions. Future studies should explore alternative treatments that effectively manage ADHD in the context of bipolar disorder and substance use, with a focus on minimizing the risk of addiction and mood destabilization."

Addiction (Opioid and Alcohol) • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • Bipolar Disorder • CNS Disorders • Depression • Grave’s Disease • Insomnia • Major Depressive Disorder • Mood Disorders • Psychiatry • Sleep Disorder

Real-World Evidence Demonstrates Limited Use of Long-Acting Injectables Versus Oral Antipsychotics in Adult Patients With Early Phase Schizophrenia (APA 2025) - "For second line of therapy, aripiprazole (21%) had the highest proportion of use, followed by risperidone, olanzapine, and quetiapine (all 16%)...Haloperidol had the second highest proportion for first-line LAI (20%) while aripiprazole had the second highest proportion of use for second and third lines of therapy (25% and 27%, respectively)... Increasing evidence supports LAI use in early phase SZ, yet oral APs are used earlier and more frequently than LAIs. For oral APs, patients tend to evenly cycle through four major APs regardless of line of therapy while the paliperidone LAI was most common across all lines, albeit in a small subset of patients. Despite being associated with relapse prevention and improved disease outcomes, limited LAI treatment options may be contributing to the underutilization in early phase SZ."

Clinical • HEOR • Real-world • Real-world evidence • CNS Disorders • Psychiatry • Schizophrenia

Withdrawal-Emergent Dyskinesias: A Literature Review and Clinical Case Analysis (APA 2025) - "Additionally, this review integrates data from a clinical case of a 64-year-old man with schizoaffective disorder who developed withdrawal-emergent dyskinesias following abrupt discontinuation of clozapine and aripiprazole...In the presented case, dyskinetic movements resolved with reinitiation and slower tapering of antipsychotics, along with benzodiazepine and benztropine treatment... Withdrawal-emergent dyskinesias are a clinically significant phenomenon requiring further research to establish best practices for prevention and management. This review outlines and highlights the importance of cautious antipsychotic withdrawal protocols and contributes to the evolving understanding of this under-recognized complication. Optimizing tapering guidelines and developing targeted therapies are discussed."

Clinical • Review • CNS Disorders • Immunology • Movement Disorders • Psychiatry • Schizophrenia

Unsupervised Graph Clustering Reveals a Clinical Taxonomy of Antipsychotics (APA 2025) - "Cluster 1 contained Aripiprazole, Brexpiprazole, Cariprazine, Lurasidone, Sertindole, and Ziprasidone, and was characterized by an excellent side-effect profile but also with the lowest efficacy. Cluster 2 contained Chlorpromazine, Haloperidol, Loxapine, Molindone, Perphenazine, and Thiothixene, and showed strong efficacy in positive symptoms, but also had a high-risk for EPS, QTc prolongation and seizures. Cluster 3 contained Clozapine, Iloperidone, Olanzapine, Quetiapine, Thioridazine, and Zotepine, and showed strong overall efficacy but carried the highest risk for sedation and metabolic side effects. Cluster 4 contained Amisulpride, Asenapine, Paliperidone, Risperidone, and Sulpride, and showed excellent positive and negative symptom efficacy but carried the highest risk of hyperprolactinemia. Cluster 5 contained Flupentixol, Fluphenazine, Pimozide, and Trifluoperazine and showed the lowest efficacy with a high risk of causing EPS. Conclusion Despite traditional..."

Clinical • Anesthesia • CNS Disorders • Epilepsy • Hypotension • Psychiatry • Schizophrenia

Sulfhemoglobinopathy and Hemolytic Anemia Resulting in Acute Hypoxic Respiratory Failure Secondary to Isobutyl Nitrite Inhalation (ATS 2025) - "Case: A 36-year-old man with history of schizophrenia on paliperidone and aripiprazole presented to clinic with subacute nausea, vomiting, and hypoxia requiring Emergency Department evaluation and subsequent admission...Typical agents include but are not limited to acetanilide, phenacetin, nitrates, nitroglycerine, trinitrotoluene, metoclopramide, methylene blue, and sulfur compounds. Isobutyl nitrite, was also implicated as the driver of hemolytic anemia. This case illustrates a rare, but clinically impactful, diagnosis of sulfhemoglobinemia secondary to inhaled isobutyl nitrite."

Anemia • Cardiovascular • CNS Disorders • Heart Failure • Hematological Disorders • Hepatology • Infectious Disease • Pain • Pneumonia • Psychiatry • Pulmonary Embolism • Respiratory Diseases • Schizophrenia