Comparative Study of Efficacy and Safety of Amisulpride and Aripiprazole in Patients of Schizophrenia in a Tertiary Care Centre of Eastern India

Introduction: The key to evidence-based medicine is to identify similarities and differences between available drugs. There is difference among antipsychotic drugs with respect to frequency of common adverse effects clearly differ in propensity for causing common side-effects, such as extrapyramidal symptoms and weight gain, but meta-analyses also suggest a hierarchical structure for efficacy. Based on results of meta-analysis, amisulpride and amisulpride were found to be most effective drugs among first line antipsychotics. Aims/ objective: To generate further evidence for decreasing controversies, we had planned this study to compare the efficacy and safety of amisulpride and aripiprazole in patients of schizophrenia. Materials and Method: Change in mean PANSS total score; change in mean PANSS positive, negative, and general subscale score; change in mean CGI-S (Clinical Global Impression–Severity of Illness scale) and change in mean GAF (Global Assessment of Functioning) score from baseline to 1 year were compared between two groups. Patients were assessed for these outcome measures at baseline, 1 month, 3 months, 6 months, and 12 months. Categorical data were compared using fisher’s exact test and continuous data were compared using unpaired t test. P-value less than 0.05 was taken as measure of statistically significant difference. Results: Amisulpride was found superior to aripiprazole in pharmacotherapy of schizophrenia with regards to total PANSS score. There was significant improvement in positive and negative symptoms in both groups (p<0.0001). However, there was statistically significant better result in amisulpride groups with regard to PANSS positive subscale score (p<0.0001). The efficacy of amisulpride on improvement in negative symptoms was better than the improvement in positive symptoms. Conclusion: Amisulpride was found more efficacious than aripiprazole regarding improvement in positive and negative symptoms and total PANSS score. Both amisulpride and aripiprazole had no significant effect on weight gain and extrapyramidal symptoms. Increase in dose of amisulpride had also no significant effect on frequency of adverse events.