The Impact Of Aripiprazole Once-Monthly Initiation and Persistence On Concomitant Psychiatric Medications In Adults Diagnosed With Bipolar I Disorder: A Retrospective Analysis Of Claims Data From The United States

Bipolar I disorder (BP-I) is characterized by extremes of the mood spectrum. People diagnosed with BP-I often have comorbid mental health conditions, necessitating the use of additional psychiatric medications. This real-world retrospective analysis utilized deidentified claims data from the MarketScan Medicaid database to evaluate the impact of aripiprazole once-monthly (AOM; a long-acting injectable antipsychotic) treatment initiation and persistence on concomitant psychiatric medication use in adults diagnosed with BP-I.
The study included patients diagnosed with BP-I who received AOM between January 2018 and December 2021. In patients persistent on AOM for 12 months (i.e., < 60 days between AOM injections), concomitant psychiatric medication use was assessed during the 12-month periods pre- and post-AOM initiation. Descriptive statistics for counts/proportions of patients with medication use in the periods pre- and post-AOM initiation were reported, and a McNemar’s test was used to test for differences between pre- and post-counts.
A total of 1,815 patients were included, with a mean (standard deviation) age of 36.3 (12.0) years. Approximately 20% (n=364) of patients were persistent on AOM for 12 months and were included in the concomitant medication-use assessment. A significant reduction in concomitant medication use was observed post-AOM initiation for major classes of antidepressants (SSRI/SNRIs; pre-AOM: 47.3%, post-AOM: 41.2%; p=0.009); insomnia medications (pre-AOM: 40.1%, post-AOM: 34.1%; p=0.024); oral atypical antipsychotics (pre-AOM: 40.4%, post-AOM: 22.8%; p < 0.001) and injectable atypical antipsychotics (pre-AOM: 6.3%, post-AOM: 0.5%; p < 0.001).
In patients diagnosed with BP-I, AOM treatment initiation and persistence is associated with reductions in concomitant use of psychotropic medications.