Depression Severity May Predict Akathisia Risk With Aripiprazole Augmentation in Older Adults

Adding the antipsychotic aripiprazole to an antidepressant regimen can benefit older patients with treatment-resistant depression, but the strategy comes with risks: aripiprazole augmentation can cause extrapyramidal symptoms, such as akathisia and parkinsonism, according to astudy in theJournal of Clinical Psychiatry. Thus, clinicians need to pay close attention when prescribing aripiprazole to older patients with more severe depressive symptoms.Jonathan H. Hsu, M.D., of the University of Toronto, and colleagues analyzed data collected during arandomized, controlled trial evaluating the efficacy and safety of aripiprazole augmentation for adults aged older than 60 years with treatment-resistant depression. Patients who did not achieve remission after receiving venlafaxine extended-release (up to 300 mg/day) for 12 weeks were randomly assigned to receive aripiprazole augmentation (maximum dose 15 mg/day) or placebo for 12 weeks. Throughout the trial, the researchers assessed patients for extrapyramidal symptoms.Forty (44%) of the 91 participants randomly assigned to aripiprazole achieved remission compared with 26 (29%) of 90 randomly assigned to placebo —a significant difference. Akathisia was the most common adverse effect of aripiprazole; 24 (26.7%) developed akathisia compared with 11 (12.2%) of participants assigned to placebo. Those who developed akathisia had higher depression severity at baseline. Aripiprazole was also associated with more parkinsonism; 15 people in...
Source: Psychiatr News - Category: Psychiatry Tags: akathisia aripiprazole depression extrapyramidal symptoms Jonathan H. Hsu Journal of Clinical Psychiatry older adults Parkinsonism Source Type: research