Efficacy and Tolerability of Aripiprazole in a Nigerian Cohort with First-episode Psychosis: A Post-marketing Survey

Background: Individuals with first episode psychoses often discontinue pharmacotherapy due to poor symptom remission and/or intolerable side effects. Aripiprazole has been reported to show good efficacy with low side effect profiles in Caucasians. No studies have been conducted to assess its effectiveness and tolerability in a Nigerian population hence the need for this study.

Methods: A post marketing surveillance was conducted involving patients with first episode psychosis presenting to a regional tertiary psychiatric facility in Nigeria. Participants were titrated through a dose range of 10-30 mg of aripiprazole depending on response or tolerability and followed up over a 12 week period. Assessments at baseline, at 2, 6, and 12-weeks post recruitment were done to rate severity of psychopathology (CGI, PANSS), side effects (MSAS), functioning (GAF), and medication adherence (MARS).

Results: Of fifty patients completing the study (49.5% drop-out rate), we observed significant improvements at 12 weeks compared to baseline in symptom remission (p<0.001), clinician rating of improvement (p<0.01), and psychosocial functioning (p<0.001). There were no significant changes compared to baseline as regards medication adherence, extra pyramidal side effects (p=0.23), fasting blood sugar (p=0.67) and fasting cholesterol (p=0.57)

Conclusion: Aripiprazole may be effective and tolerable among individuals with first episode non-affective psychoses presenting at a tertiary psychiatric facility in Nigeria.