Abilify Therapy for Reducing Comorbid Substance Abuse
Condition: Schizophrenia; Schizoaffective Disorder; Bipolar Disorder; Major Depressive Disorder; Anxiety Disorders; Substance Abuse
MeSH terms: Substance-Related Disorders; Schizophrenia; Depressive Disorder; Depressive Disorder, Major; Bipolar Disorder; Anxiety Disorders; Psychotic Disorders
Study type: Interventional
Phase: Phase 4

Summary: 
      It is hypothesized that the use of aripiprazole (Abilify) in patients with alcohol and/or
      drug dependence with comorbid psychiatric conditions will lead to:

        -  Reduction in the amount of alcohol and/or drugs used as measured by the Time Line Follow
           Back (TLFB) and the Addiction Severity Index (ASI)

        -  Reduction in cravings for alcohol and drugs as measured by the Penn Alcohol Craving
           Scale

        -  Reduction in symptoms of co-morbid psychiatric disorders compared to before starting
           aripiprazole.
    

Detailed description: 
      Substance abuse disorders are a major public health problem. With a current prevalence rate
      of 18%, substance abuse and dependence costs the nation over $300 billion per year in
      treatment costs and lost productivity. Approximately 20% of all patients attending primary
      care clinics and 35% of all patients attending psychiatric clinics meet Diagnostic and
      Statistical Manual IV (DSM IV) criteria for substance abuse or dependence.

      The treatment of substance abuse and dependence disorders is complex and involves individual
      and group therapy, maintenance of sobriety, commitment to structured living, and
      participation in self-help groups. To date, pharmacotherapy for substance dependence
      disorders has had limited success. Several medications have been tested in the past,
      including tricyclic antidepressants, selective serotonin reuptake inhibitors, buspirone,
      bupropion, venlafaxine, nefazodone, bromocriptine, amantadine, naltrexone, and acamprosate.
      Of these, naltrexone has obtained an FDA indication for treatment of alcohol dependence, and
      acamprosate is in use in Europe. However, these medications are effective in only a
      relatively small proportion of patients. Benzodiazepines may be useful in treatment of
      withdrawal syndromes, but their potential for abuse and dependence limits their use in
      maintenance treatment.

      This is an open label pilot study of aripiprazole therapy in the treatment of patients with
      substance use disorders and co-morbid disorders like Schizophrenia, Schizoaffective disorder,
      Bipolar disorder, Major depressive disorder, Anxiety (Panic disorder, Generalized Anxiety
      Disorder, Post-Traumatic Stress Disorder). While Aripiprazole has been approved for the
      treatment of Schizophrenia, its use in other psychiatric disorders is off label use.
      Increasing evidence suggests that Aripiprazole might offer some benefit for other psychiatric
      disorders besides Schizophrenia.
    

Intervention name(s): Aripiprazole
Intervention type(s): Drug
Intervention MeSH terms: Aripiprazole
Allocation: Non-Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Comorbid substance abuse/dependence; Comorbid diagnoses; Substance abuse and/or dependence