MEDIX, God. 19 Br. 106  •  Sponzorirani članak  •  Psihijatrija HR ENG

Aripiprazol: nove mogućnosti u liječenju shizofrenije i bipolarnog poremećajaAripiprazole: new possibilities in the treatment of schizophrenia and bipolar disorder

Miro Jakovljević

Aripiprazol, potentni antipsihotik nove generacije, s antimaničnim i antidepresivnim učinkom ovisno o dozi, bitno se razlikuje od drugih antipsihotika zbog čega otvara nove mogućnosti u liječenju shizofrenije i bipolarnog poremećaja. Radi se o parcijalnom agonistu D2-dopaminskih receptora, tako da u manjim dozama pojačava, a u većim smanjuje aktivnost dopaminskog sustava, te o parcijalnom agonistu 5-HT1A-receptora i antagonistu 5-HT2A-receptora. Ovaj specifični farmakodinamski profil aripiprazola omogućuje njegova specifična terapijska klinička djelovanja i odsustvo određenih nuspojava koje imaju drugi antipsihotici. Aripiprazol pokazuje povoljan učinak i na pozitive (produktivne) i na negativne (deficitarne) simptome shizofrenije, te manične, ali i na depresivne simptome (u skladu s dozom), a sve to bez povećanja tjelesne težine i metaboličkog sindroma, produljenja QTc-intervala, ekstrapiramidalnih nuspojava i hiperprolaktinemije. Također, smanjuje poriv i žudnju za uzimanjem kokaina i alkohola u bolesnika sa shizofrenijom i dualnom dijagnozom alkoholizma i kokainomanije. Dokazan je i povoljan učinak na kompulzivne simptome u bolesnika s opsesivno-kompulzivnim poremećajem koji se često javlja u komorbiditetu sa shizofrenijom.

Ključne riječi:
aripiprazol; bipolarni afektivni poremećaj; kreativna psihofarmakoterapija; medicina utemeljena na dokazima; shizofrenija

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 19 Br. 106

Aripiprazole, a new potent antipsychotic with antimanic and antidepressant effects depending on the dosage, is significantly different from other antipsychotics and opens up new possibilities for the treatment of schizophrenia and bipolar disorder. It is a partial agonist with D2-dopamine receptors, where lower doses increase and higher doses decrease the dopamine system activity, as well as a partial 5-HT1A-receptor agonist and 5-HT2A receptor antagonist. This specific pharmacodynamics profile of aripiprazole allows its specific clinical therapeutic activity with the absence of certain side effects of other antipsychotics. Aripiprazole exhibits a favorable effect on the positive (productive) and negative (deficit) symptoms of schizophrenia, manic as well as depressive symptoms (according to the dose), all without increasing bodyweight and metabolic syndrome, prolongation of QTc-intervals, extrapyramidal side effects and hyperprolactinemia. It also reduces the urge and desire for cocaine and alcohol in patients with schizophrenia and dual diagnosis of alcoholism and cocaine addiction. There are also positive effects on compulsive symptoms and behaviors in patients with obsessivecompulsive disorder which often occur in comorbidity with schizophrenia 

Key words:
aripiprazole; bipolar disorder; creative psychopharmacotherapy; evidence based medicine; shizophrenia