Clinical Report: Evaluating Aripiprazole as a Secondary Treatment Option

Overview

This preliminary retrospective analysis evaluated aripiprazole as a second-line treatment for refractory functional dizziness disorders, including PPPD. The study found a 75% response rate, indicating potential efficacy in patients who did not respond to first-line serotonergic agents.

Background

Persistent postural-perceptual dizziness (PPPD) is a prevalent chronic vestibular disorder affecting a significant portion of patients with chronic dizziness. First-line treatments, primarily serotonergic antidepressants, have a response rate of only 60-65%, leaving many patients with unresolved symptoms. This highlights the need for alternative therapeutic options, such as aripiprazole, which may address underlying dopaminergic dysregulation.

Data Highlights

Key Findings

• 75% of patients showed improvement on the CGI-I scale after aripiprazole treatment.
• Four patients did not respond to treatment, and one discontinued due to extrapyramidal side effects.
• Improvements were noted in Dizziness Handicap Inventory (DHI) and Niigata PPPD Questionnaire (NPQ) scores among evaluable patients.
• No significant changes were observed in foam posturography results.
• Aripiprazole's multimodal mechanism may target symptoms inadequately addressed by serotonergic agents.

Clinical Implications

Aripiprazole may be a viable second-line treatment option for patients with refractory functional dizziness disorders, particularly those with PPPD. Clinicians should consider its use in patients who do not respond adequately to first-line serotonergic therapies, while monitoring for potential side effects.

Conclusion

The findings suggest that aripiprazole may offer a promising alternative for managing refractory functional dizziness disorders. Further prospective studies are needed to validate these preliminary results.

Related Resources & Content

1. BMC Psychiatry (Springer), 2025 -- Monotherapy with Aripiprazole in Bipolar Disorder Patients Experiencing Delayed Sleep-Wake Phase Syndrome: A Case Series Analysis
2. BMC Psychiatry (Springer), 2025 -- Assessing the metabolic impact of aripiprazole versus risperidone in the treatment of schizophrenia: a randomized double-blind controlled clinical trial
3. Frontiers in Neurology, 2026 -- Editorial: Mechanisms of functional dizziness: a window for understanding space-motion cognition
4. Drugs - Real World Outcomes, 2020 -- Monthly Long-Acting Injectable Aripiprazole for Schizophrenia Patients with Concurrent Substance Use Disorders: Findings from a Multicenter Observational Study
5. Frontiers, 2025 -- Effect of conservative therapy for persistent postural-perceptual dizziness: a systematic review and meta-analysis
6. ScienceDirect -- A case of refractory dizziness effectively treated with the addition of aripiprazole to antidepressant therapy
7. 2025 German Primary Care Dizziness Guideline
8. Frontiers | Effect of conservative therapy for persistent postural-perceptual dizziness: a systematic review and meta-analysis
9. A case of refractory dizziness effectively treated with the addition of aripiprazole to antidepressant therapy - ScienceDirect