Aripiprazole demonstrated sufficient efficacy in the treatment of manic episodes of bipolar affective disorder in randomised double-blind trials. The antimanic effect resulted in about 50% responders with a rapid onset of action within 2-4 days and after intramuscular administration within 45-60 minutes without excessive sedation.
The long-term prophylaxis significantly reduced manic but not depressive relapses. Aripiprazole was effective in reducing the euphoric, psychotic, mixed and rapidly cycling forms of mania.
Aripiprazole was well tolerated and unlike the other antipsychotics did not induce metabolic side effects and hyperprolactinaemia. Its successful use requires knowledge of a specific strategy for switching from other antipsychotics and management of akathisia.
Aripiprazole effectively expands the currently used variety of antimanics.