Aripiprazole is a relatively new atypical antipsychotic and is positioned as the ‘second generation’ atypical. In schizophrenia the drug has shown good efficacy and a clean tolerability profile (specifically, it lacks important side effects of other atypical antipsychotics such as weight gain, EPS, prolactin elevation, or diabetes). This tolerability positioning will extend into bipolar disorder, where BMS can be expected to position aripiprazole as the atypical of choice for the short- and long-term management of bipolar symptoms.

Strengths

• Well-documented efficacy in acute mania.
• Less weight gain, hormonal changes and EPS compared with other atypical antipsychotics, i.e. 'a different path to success'.

Weaknesses

• Limited data are available in bipolar maintenance.
• No evidence for maintenance efficacy in bipolar depression.