Aripiprazole: features and use in the aged

Abstract Aripiprazole was the first dopamine 2 receptor partial agonist among antipsychotics. It was approved by the Food and Drug Administration (FDA) for the treatment of schizophrenia in 2002 and received later additional approvals for Bipolar Disorder type I and for the adjunctive treatment of major depressive disorder. At low doses, it’s also used for the treatment of antipsychotic-induced hyperprolactinemia. Elderly patients do not need any dosage reduction either, and no significant pharmacokinetic changes occur in patients with severe renal impairment. Nevertheless, despite assertions that no dosage adjustment is needed based on age only, it is wise to start at the low end of the dosing range, given the greater frequency of decreased hepatic, renal, or cardiac function and of concomitant disease or other drug therapy in elderly patients. Two different long-acting intramuscular (depot) formulations have also become available. On the other hand, we have recently shown that the use of the imprecise term month might have deep implications in pharmacotherapy and should be avoided. Finally, there is growing evidence showing that aripiprazole, among other psychotropics, may pose a risk for the environment.