Indication(s)
The treatment of schizophrenia and related psychotic disorders, manic or mixed episodes in bipolar I disorder, and for use as an adjunct to antidepressants for the treatment of Major Depressive Disorder (MDD) in patients who had inadequate response to prior antidepressant treatments during the current episode.
Formulary status
The Drug Advisory Committee (DAC) recommended that generic aripiprazole be listed on psychotraumatic (22WS) and serious injury services (27WS) formularies. WSIB accepts the DAC recommendation for listing.
Recommendation highlights
- Aripiprazole is an atypical second-generation antipsychotic, and is the only pharmacotherapy approved by Health Canada for adjunctive treatment of MDD in adults who had an inadequate response to prior antidepressant therapy.
- Aripiprazole is moderately effective as an adjunct in treatment of resistant MDD. There are no randomized, controlled trials (RCTs) with active comparator second-generation antipsychotics vs. aripiprazole for this indication.
- There are two recent RCTs comparing aripiprazole to bupropion augmentation or switching. Aripiprazole treatment resulted in a statistically significant but clinical modest increased likelihood of remission compared to bupropion.
- Aripiprazole has a favorable side effect profile in comparison with other second generation antipsychotics.
- CANMAT 2016 Clinical Guidelines for the Management of Adults with MDD recommend aripiprazole as a first line adjunctive medication for nonresponse or partial response to an antidepressant.
- Daily cost of generic aripiprazole in treatment of resistant MDD is comparable to other formulary- listed alternatives.
- Aripiprazole is covered by the Ontario Drug Benefit Program.
- Based on the published evidence and the introduction of generic aripiprazole, the DAC recommended formulary addition of generic aripiprazole.
Drug profile
Products available in Canada:
- Aripiprazole 2 mg, 5 mg, 10 mg, 20 mg and 30 mg tablets (abilify® and generics)
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