The efficacy and safety of ARI in the treatment of schizophrenia
I. Research Overview and Objectives
Schizophrenia is a severe mental disorder that has emerged as a significant health issue, second only to cerebrovascular diseases in terms of its substantial societal impact. Finding highly effective and safe treatment options remains a core clinical priority. The atypical antipsychotic risperidone is widely used in the treatment of schizophrenia, but it can cause side effects such as metabolic abnormalities and extrapyramidal reactions [1]. Aripiprazole, a novel dopamine system stabiliser, has garnered significant attention due to its unique mechanism of action. Xiong Yongzhi et al. [2] conducted a study that aimed to systematically evaluate the efficacy and safety of aripiprazole versus risperidone in improving psychotic symptoms, cognitive function, and neurorelated factors in patients with schizophrenia through a comparative analysis.
II. Research Design and Methods
This study used a parallel-group design to assign 96 patients with a first episode of schizophrenia to either the aripiprazole group (the study group) or the risperidone group (the control group). There were 48 patients in each group. The treatment duration was two months. The study group received oral aripiprazole, starting at 5 mg per day and increasing to 30 mg per day within two to three weeks, administered once daily. The control group received oral risperidone, starting at 1 mg/day and titrated to 6 mg/day within one to two weeks, also administered once daily. During treatment, both groups could use beta-blockers and anticholinergic drugs to manage adverse reactions.
The Psychotic Symptom Assessment Scale (PANSS) [3] and the Montreal Cognitive Ability Battery (MCCB) [4] were used to assess psychotic symptoms and cognitive function in both patient groups. Serum levels of neurotrophic factors (BDNF, NGF and NT-3) were measured as biological markers. Any adverse reactions experienced during treatment were recorded, enabling a comprehensive evaluation of efficacy and safety to be conducted across both groups.
● Therapeutic Efficacy Advantage
∠ Superior Symptom Improvement: At one week and one month after the intervention, the PANSS total scores in the aripiprazole group were significantly lower than in the risperidone group (p<0.05), suggesting that aripiprazole provides faster and more effective relief from overall psychotic symptoms [2].
∠ Significant improvement in cognitive function: During the same period, the MCCB scores of patients in the aripiprazole group were significantly higher than those in the risperidone group (P < 0.05). This suggests that aripiprazole may be more effective at improving cognitive domains such as attention, memory and executive function [2].
∠ Higher overall response rate: The response rate was significantly higher in the aripiprazole group (95.83%) than in the risperidone group (75.00%) [2].
● Effects on neurotrophic factors
∠ After one month of treatment, serum levels of BDNF, NGF and NT-3 increased significantly in both groups compared to baseline levels. However, the aripiprazole group experienced a significantly greater increase than the risperidone group (P<0.05) [2].
● Safety analysis
∠ During the two-month observation period of this study, the incidence rate of adverse reactions in the aripiprazole group (6.25%) was not statistically different to that in the risperidone group (10.42%) (P>0.05), with both groups exhibiting low rates of occurrence [2]. There were no reports of somnolence in the aripiprazole group, with an incidence of weight gain of only 2.08%, compared to 4.17% in the risperidone group.
This study provides positive evidence of the short-term efficacy and safety of aripiprazole in the treatment of first-episode schizophrenia. It demonstrates particular advantages in improving cognitive function and upregulating neurotrophic factors. However, to implement comprehensive patient management and maximize therapeutic benefits while minimizing risks, clinicians should integrate longer-term study data and other real-world safety evidence.
Reference：
[1]张瑞,杨春.帕利哌酮和阿立哌唑治疗精神分裂症患者的效果比较[J].中国医药导报,2022,19(22):153-156.
[2]熊永志,骆翠萍.阿立哌唑治疗精神分裂症疗效与安全性研究[J].天津药学,2024,36(6):69-72.
[3]司天梅,杨建中,舒良,等.阳性和阴性症状量表(PANSS,中文版)的信、效度研究[J].中国心理卫生杂志,2004,18(1):45-47.
[4]丁欣,石川,姚树桥,等.MATRICS扩展认知成套测验中国常模制定[J].中华医学会第十次全国精神医学学术会议论文汇编,2012:41-42.
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