Effectiveness of switching to long-acting injectable aripiprazole in patients with recent-onset and chronic schizophrenia
Sung-Wan Kim 1, Bong-Ju Lee 2, Eun-Jin Cheon 3, Seung-Hee Won 4, Anna Jo 1, Jae-Min Kim 1, Young-Chul Chung 5*
1Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea, 2Department of Psychiatry, Inje University Haeundae Paik Hospital, Inje University College of Medicine, 3Department of Psychiatry, College of Medicine, Yeungnam University, 4Department of Psychiatry, Kyungpook National University School of Medicine, 5Department of Psychiatry, Chonbuk National University Medical School
Received: April 25, 2021; Revised: June 18, 2021; Accepted: July 6, 2021; Published online: July 6, 2021.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Objective: This study investigated the effectiveness of switching to once-monthly long-acting injectable (LAI) aripiprazole from other second-generation antipsychotics including LAI paliperidone palmitate in both recent-onset and chronic schizophrenia patients.
Methods: This was a 24-week prospective, open-label, flexible dose-switching study in patients with schizophrenia. Scores on the Positive and Negative Syndrome Scale (PANSS), Personal and Social Performance (PSP) scale, Clinical Global Impression (CGI), Subjective Well-being Under Neuroleptics–Short Form (SWN-K), and a computerized emotional recognition test (ERT) were evaluated. Subjects were divided into two groups (recent onset and chronic) based on 5 years’ duration of the illness.
Results: Among the 82 patients participating, 67 (81.7%) completed the 24-week study. The discontinuation rate after switching to LAI aripiprazole did not differ according to clinical characteristics including type of previous antipsychotics. Scores on the PANSS, PSP, SWN-K, CGI, and ERT were significantly improved after a switch to LAI aripiprazole without exacerbation of metabolic parameters and bodyweight. The improvements in the PANSS, PSP, and CGI scores were significantly greater in patients with recent-onset than in those with chronic schizophrenia; the improvement in metabolic parameters was significantly greater in the latter group.
Conclusion: High rates of successful switching to LAI aripiprazole from other antipsychotics suggest its good tolerability and effectiveness. Improvements in psychopathology and social functioning were more evident in patients with recent-onset schizophrenia, and improvements in metabolic abnormalities were more prominent in patients with chronic schizophrenia.
The trial register and clinical trial registration number: (ClinicalTrials.gov) NCT03839251
Keywords: long-acting injection, aripiprazole, switching, schizophrenia, recent-onset