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Content Update

December 12, 2023

Abilify Asimtufii®: A Newly Approved Bimonthly Long Acting Injectable: A new dosage form of aripiprazole monohydrate (Abilify Asimtufii®), was approved by the U.S. Food and Drug Administration (FDA) in April 2023 for schizophrenia and maintenance monotherapy treatment of bipolar I disorder. It is a 960 mg long-acting injectable administered into the gluteal muscle every 2 months, in contrast to Abilify Maintena®, which is administered monthly into the deltoid or gluteal muscle. In a 32-week open-label trial, Abilify Asimtufii® showed comparable aripiprazole plasma concentrations (geometric means ratio 1.011) and treatment-emergent adverse events (71.2% vs. 70.9%) to Abilify Maintena®. This newly approved formulation represents a step forward in offering patients more convenient and tolerable treatment options, enhancing adherence rates, and improving quality of life for individuals suffering from severe psychiatric disorders.

Content Update

May 09, 2022

Lybalvi® Use in Patients with Bipolar I Disorder and Schizophrenia: Lybalvi® is a combination drug that contains olanzapine, a second-generation antipsychotic, and samidorphan, an opioid antagonist. It was U.S Food and Drug Administration approved in 2021 for the treatment of schizophrenia and for symptoms of psychosis associated with bipolar I disorder. Use of Lybalvi ® aims to increase medication adherence, treat and prevent metabolic comorbid conditions, and improve patient quality of life.

LEARNING OBJECTIVES

LEARNING OBJECTIVES

Upon completion of the chapter, the reader will be able to:

  1. Explain the pathophysiologic mechanisms underlying bipolar disorder.

  2. Recognize the symptoms of a manic episode in patients with bipolar disorder.

  3. Identify common psychiatric comorbidities of bipolar disorder.

  4. Recognize the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), criteria for bipolar disorder as well as the subtypes of bipolar I disorder, bipolar II disorder, and cyclothymic disorder.

  5. List the desired therapeutic outcomes for patients with bipolar disorder.

  6. Identify the optimal use of medications as first-line therapy in bipolar disorder, including appropriate dosing.

  7. Recommend drug therapy for acute treatment of mania and depressive episodes.

  8. Recommend baseline and routine monitoring for assessment of adverse effects of medications used in the treatment of bipolar disorder.

  9. Identify general treatment differences for agents used to treat bipolar disorder in the pediatric population.

  10. Explain why medication education is important for patients with bipolar disorder.

INTRODUCTION

Bipolar disorder is characterized by one or more episodes of mania or hypomania, in addition to one or more major depressive episodes.1 It is chronic, with recurrent episodes and remissions. Mood episodes can be manic, hypomanic, or depressed, and each separated by periods of long stability or cycle rapidly. They occur with or without psychosis. Disability and other consequences (eg, increased risk of suicide) can be devastating to patients and families. Correct and early diagnosis and treatment are essential to prevent complications and maximize response to treatment.

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