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Aripiprazole monotherapy as transdiagnostic intervention for the treatment of mental disorders: An umbrella review according to TRANSD criteria
Univ Padua, Italy; Kings Coll London, England.
Univ Padua, Italy.
Univ Milan, Italy.
Univ Pavia, Italy; Univ Toronto, Canada; Ctr Addict & Mental Hlth, Canada.
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2020 (English)In: European Neuropsychopharmacology, ISSN 0924-977X, E-ISSN 1873-7862, Vol. 41, p. 16-27Article, review/survey (Refereed) Published
Abstract [en]

Aripiprazole is approved in different countries as treatment for several mental disorders, but its transdiagnostic potential has not yet been assessed according to established criteria such as the recently proposed TRANSD criteria. The present work aims to test whether aripiprazole monotherapy could be considered a transdiagnostic intervention. An umbrella review of meta-analyses of randomized controlled trials (RCTs) of aripiprazole monotherapy vs placebo was conducted for any disorder defined according to standard diagnostic criteria. Primary outcomes were levels of psychiatric disease-specific symptoms. TRANSD criteria were applied to assess transdiagnosticity, while the AMSTAR-2 tool was used to assess the quality of eligible meta-analyses. Four pairwise meta-analyses and three network meta-analyses were included, consisting of 25 RCTs of aripiprazole monotherapy vs. placebo (N = 5469). Aripiprazole outperformed placebo on primary outcomes in Alzheimers disease with behavioral disturbance (AD) (neuropsychiatric symptoms SMD 0.20, 95%CI 0.05-0.35, max 15 mg/day), autism spectrum disorder (ASD) (severity of symptoms SMD 0.39, 95%CI 0.30-0.48, max 15 mg/day), bipolar I disorder (BD) (severity of manic symptoms SMD 0.30, 95%CI 0.12-0.47, max 30 mg/day), and schizophrenia/schizoaffective disorder (response rate RR 0.84, 95%CI 0.78-0.92, max 30 mg/day). TRANSD criteria were met (pooled SMD 0.25, 95%CI 0.09-0.41) across these disorders Quality was high in all the included meta-analyses according to AMSTAR-2. According to TRANSD criteria, aripiprazole monotherapy is a (dose-specific) transdiagnostic intervention to treat psychiatric disease-specific symptoms across 5 diagnoses (AD, ASD, BD (mania), schizophrenia/schizoaffective disorder), across four DSM-5 diagnostic groups (neurocognitive disorders, neurodevelopmental disorders, bipolar and related disorders, schizophrenia spectrum and other psychotic disorders). (c) 2020 Elsevier B.V. and ECNP. All rights reserved.

Place, publisher, year, edition, pages
ELSEVIER , 2020. Vol. 41, p. 16-27
Keywords [en]
Trans-diagnostic; Aripiprazole; Umbrella review; Meta-analysis; Schizophrenia; Psychopharmacology
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:liu:diva-172620DOI: 10.1016/j.euroneuro.2020.09.635ISI: 000596581200003PubMedID: 33077324OAI: oai:DiVA.org:liu-172620DiVA, id: diva2:1521646
Note

Funding Agencies|Spanish Ministry of Science and InnovationSpanish Government [PI15/00283, PI18/00805]; ISCIII-Subdireccion General de Evaluacion; Fondo Europeo de Desarrollo Regional (FEDER)European Union (EU); Instituto de Salud Carlos IIIInstituto de Salud Carlos III; CIBER of Mental Health (CIBERSAM); Secretaria dUniversitats i Recerca del Departament dEconomia i Coneixement [2017 SGR 1365]; CERCA Programme; Departament de Salut de la Generalitat de CatalunyaGeneralitat de Catalunya [SLT006/17/00357]

Available from: 2021-01-24 Created: 2021-01-24 Last updated: 2021-01-24

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