Aripiprazole was superior to risperidone on metabolic outcomes and symptoms alleviation in the first large-scale, double-masked randomized comparison of the two medications. The exception is in individuals where akathisia is worrisome.
The study was conducted in 198 patients between 15 and 40 years of age with schizophrenia, schizophreniform disorder, schizoaffective disorder, or unspecified psychotic disorder. All had never been treated with antipsychotics for more than 2 weeks prior to the trial. They were assigned to either aripiprazole 5 to 30 mg/day or risperidone 1 to 6 mg/day for 12 weeks.
There was no significant difference in positive symptom response rates or in time to response. Those on aripiprazole experienced better negative symptoms outcomes. They also had more akathisia.
Additionally, BMI change was not different in the 2 contingents. Investigators observed better total and LDL cholesterol, fasting glucose, and prolactin levels in the aripiprazole group. They also saw advantages on depressed mood in the aripiprazole cohort.
Citation: Robinson D, Gallego J, John M, et al. Psychosis prevention: A randomized comparison of aripiprazole and risperidone for the acute treatment of first-episode schizophrenia and related disorders: 3-Month Outcomes. Schizophr Bull. 2015;41(6):1227-1236.