Table 4: Studies with aripiprazole, amisulpride and aiprasidone

Author; No. of patients Design; Duration, Intervention Outcomes Results
ARIPIPRAZOLE
Warsi et al. (2005) [68] n=1 CR 2 months SCH + AD ARI (20 mg/d) Psychiatric symptoms (BPRS) Daily alcohol used Alcohol craving (PCS, SRCS) ARI was associated with an improvement in psychiatric symptoms, cessation of daily alcohol intake and reduction in alcohol craving
Beresford et al. (2005) [69] n=10 Pros, OL study 8 weeks SCH + COD ARI (maximum 15 mg/d) Psychiatric symptoms (BPRS) Cocaine and alcohol craving (UTS, BCRS) Positive UTS dropped significantly (p< 0.001) Mean cocaine (p=0.026) and alcohol (p=0.006) craving scores significantly declined Declining psychosis scores were significantly associated with declining cocaine and alcohol craving (p< 0.01)
Brown et al. (2005) [70] n=20 OL study 12 weeks BD (n=19) or SAD (n=1) + AD (n=17) and/or COUD (n=9) ARI (up to 30 mg/d) Psychiatric symptoms (YMRS, HDRS, BPRS) Substance craving (VAS) Substance use (days of use/week, money spent on substances/week and UTS) ARI was associated with significant improvements in psychiatric symptoms (p< 0.05), significant reductions in alcohol craving (p=0.003) and money spent on alcohol/week (p=0.042) and significant reductions in cocaine craving (p=0.014). No significant changes were observed in days/week of alcohol and cocaine use, and in money spent on cocaine/week
Kim et al. (2010) [37] n=139 Pros, RCT 8 weeks SCH + ND OLZ (n=32) or RIS (n=41) or ARI (n=31) or HAL (n=35) Psychopathology (SANS, SAPS) EPS (AIMS) Severity of ND and cigarette craving (FTQ) No significant differences in the degrees of change in psychiatric symptoms among the four groups. At 8 weeks, HAL was associated with higher EPS (p< 0.01).HAL was associated with less reduction in the severity of ND (p< 0.01) and cigarette craving (p< 0.01) compared to AAP. Among AAP, RIS increased cigarette craving (p=0.03), there were no significant changes in ND severity and cigarette craving associated with OLZ, and ARI showed a reduction in both severity of ND and cigarette craving (p< 0.01)
Bruno et al. (2014) [71] n=20 OL study 8 weeks SAD + OD + MMT ARI (10 mg/d) + TOP (200 mg/d) Tapering and suppression of MET ARI + TOP was effective to achieve MET suppression reducing clinical symptoms
Farnia et al. (2014) [53] n=45 Pros, DB, RCT 1 year follow-up AMP induced psychosis RIS (4 mg/d) or ARI (15 mg/d) Psychopathology (SANS, SAPS) SANS and SAPS scores decreased significantly in both groups. Mean SAPS score reduction was greater in the RIS group (p< 0.001). Mean SANS score reduction was greater in the ARI group (p = 0.08)
AMISULPRIDE
Dervaux and Cazali (2007) [72] n=1 CR Over 25 months SCH + AD CLO (600-1200 mg/d) + AMS (600 mg/d) Psychopathology Alcohol addictive behaviour CLO + AMS was effective in controlling psychiatric symptoms and alcohol addictive behaviour
Mez et al. (2010) [73] n=97 Pros study 9 months SUD (alcohol, cannabis, cocaine and heroin + psychotic symptoms AMS in two ranges (100-300 mg/D or >400 mg/d, mean dose 493.5 197.1 mg/d) Psychosocial distress Craving Psychosocial functioning Overall improvement in their psychological distress, a decrease in carving and an improvement in their psychological and psychosocial functioning
ZIPRASIDONE
Stuyt et al. (2006) [38] n=55 Ret, OL 2 years SCH (61%) or SAD (54%) + SUD or AUD Polyvalent SUD (34%), Alcohol (27%), Cocaine (16%), other SUD (21%) OLZ (2.5-30 mg/d, mean dosage 18.7 mg/d) (n=15) or RIS (n=16) (2-8 mg/d, mean dosage 3.9 mg/d) or ZIP (60-160 mg/d, mean dosage 132.8 mg/d) (n=10) or TAP depot (n=10) Retention rate Success in completing a DD Programme RIS and ZIP had higher rates of retention compared to OLZ (p=0.0002 and p=0.004, for RIS and ZIP respectively) and TAP (p=0.003 and p=0.03, for RIS and ZIP, respectively). No significant differences in length of stay were found between RIS and ZIP. 88% of RIS patients and 64% of ZIP completed the DD program, whereas only 40% of patients taking TAP and 33% of patients in the OLZ successfully completed the program. This difference in successful completion was statistically significant for RIS vs OLZ (p=0.02) and TAP (p=0.017)


AAP: Atypical Antipsychotics, AD: Alcohol Dependence, AIMS: Abnormal Involuntary Movement Scale, AMP: Amphetamine, AMS: Amisulpride, ARI: Aripiprazole, BCRS: Brief rating craving scale, BD: Bipolar Disorder, BPRS: Brief Psychiatric Rating Scale, CLO: Clozapine, COD: Cocaine Dependence, COUD: Cocaine Use Disorder, CR: Case Report, DB: Double blinded, DD: Dual Diagnosis, EPS: Extrapyramidal Symptoms, FTQ: Fagerstrom Tolerance Questionnaire, HAL: Haloperidol, HDRS: Hamilton Depression Rating Scale, MET: Methadone, MMT: Methadone Maintenance Treatment, OD: Opioid Dependence, OL: Open Label, OLZ: Olanzapine, PCS: Pennsylvania Craving Scale, Pros: Prospective, RCT: Randomized Controlled Trial, Ret: Retrospective, RIS: Risperidone, SAD: Schizoaffective Disorder, SANS: Scale for the Assessment of Negative Symptoms, SAPS: Scale for the Assessment of Positive Symptoms, SCH: Schizophrenia, SRCS: Self-report Craving Scale, SUD: Substance Use Disorder, TAP: Typical Antipsychotics, TOP: Topiramate, UTS: Urine Toxicological Screens, VAS: Visual Analogue Scale, YMRS: Young Mania Rating Scale, ZIP: Ziprasidone