This case report presents two female bipolar patients, suffering from their disorders for several years, who are now on prophylactic
aripiprazole therapy. Previously given drugs were ineffective and/or caused side effects, so the
therapy had to be changed. The patients are now on
aripiprazole for two years without any affective episodes, their functioning is appropriate and there has been no need for hospitalization. The condition of the first patient has been balanced by
aripiprazole-
venlafaxine combination
therapy. The second patient was first prescribed
aripiprazole and
lithium, but because of its side effect (hypothyreosis),
lithium has been stopped after six months, so she is on
aripiprazole monotherapy for one and a half year. The initial dose of
aripiprazole was 15 and 30 mg for the two patients, which caused extrapyramidal side effects, disappearing after changing to a maintenance dose of 7.5 mg. Unfortunately at present no specific clinical or
biological markers are available for clinicians to guide their choice of medications. The two cases presented raises attention not only to the success of
aripiprazole prophylactic treatment, but also to several factors which in the future may aide the clinician in choosing the adequate pharmacological agent (gender, bipolar I
disorder, psychotic mixed episodes, partial remission during interepisodes, effectiveness of low dose
aripiprazole).