Long-term Efficacy and Tolerability of Adjunctive Aripiprazole for Major Depressive Disorder: Systematic Review and Meta-analysis
Abstract
Objective: To assess the long-term efficacy and safety of aripiprazole as an augmentation strategy for major depressive disorder (MDD). Data Sources: Ovid MEDLINE, PsycInfo, and Embase databases were systematically searched for clinical studies of adult patients with MDD on long-term aripiprazole augmentation. Study Selection and Data Extraction: Long-term follow-up was defined as ≥ 6 months. Primary outcome was remission from depression. Secondary outcome was incidence of adverse effects. Results: Four open-label studies were included in this review. Random effects meta-analysis of 3 studies (n = 2,117) revealed a weighted average remission proportion of 0.33 (0.16-0.51), showing trend of improved response with duration of treatment. Three studies (n = 2,231) provided adverse effects data. Medically significant weight gain (25%-28% participants) was higher in studies with patients receiving doses ≥ 5 mg and lower (3.5%) in a study using doses Conclusions: Aripiprazole augmentation may be an effective long-term strategy for treatment of refractory MDD. Lower maintenance doses (2-5 mg) of aripiprazole may be effective and have fewer side effects compared to larger doses (> 5 mg-10 mg).
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The study data support current pharmacological augmentation recommendations from several depression treatment guidelines that recommend atypical antipsychotics as first-line agents, specifically aripiprazole and quetiapine.
“Our data support current pharmacological augmentation recommendations from several treatment guidelines for depression which recommend the use of AAs as first line agents, specifically the use of aripiprazole and quetiapine (Kennedy et al., 2016; NICE, 2010; Seshadri et al., 2021).”
From Augmentation strategies for treatment resistant major depression: A systematic review and network meta-analysis (2022) · cites this paper as Seshadri et al., 2021
Aripiprazole as an augmentation agent at a mean dose of 10.68 ± 3.1 mg/day showed significant benefit and had low discontinuation rates.
“Aripiprazole as an augmentation agent (mean dose,10.68 ± 3.1 mg/day) showed significant benefit and had low discontinuation rates, which aligns with previous studies (Seshadri et al., 2021; Strawbridge et al., 2019).”
From Augmentation strategies for treatment resistant major depression: A systematic review and network meta-analysis (2022) · cites this paper as Seshadri et al., 2021
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- Authors
- Seshadri, A., Wermers, M. L., Habermann, T. J., & Singh, B.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Seshadri, Ashok
- Venue
- The Primary Care Companion For CNS Disorders
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2021-06-24
- Volume
- 23
- Issue
- 4
- ISSN
- 2155-7772 (ISSN-L)
- 2155-7780
- OpenAlex
- W3173375176
- Cited by
- 19
- References
- 0
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 11 · 2023: 2 · 2022: 3
- FWCI
- 2.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Primary Care Companion For CNS Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- aripiprazole, major depressive disorder, antidepressant augmentation, long-term efficacy, tolerability, remission, weight gain, akathisia, tardive dyskinesia, insomnia, sleepiness, fatigue, maintenance dose, treatment-resistant depression
- MeSH terms
- Aripiprazole, Tardive Dyskinesia, Adult, Depressive Disorder, Major, Major Depressive Disorder, Humans, Antipsychotic Agents
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