From the Guidelines
Abilify (aripiprazole) is not recommended as a first-line treatment for hoarding disorder due to insufficient evidence and its side effect profile. The primary treatments for hoarding disorder typically include cognitive-behavioral therapy (CBT) specifically designed for hoarding, sometimes combined with selective serotonin reuptake inhibitors (SSRIs) like fluoxetine or sertraline 1. If medication is being considered for hoarding symptoms, an SSRI would generally be tried first, typically starting at standard doses and potentially increasing as needed. Some key points to consider when evaluating treatment options for hoarding disorder include:
- The diagnostic criteria for hoarding disorder, which involves accumulation of possessions due to excessive acquisition or difficulties discarding them, regardless of their actual value 1
- The potential for co-occurring psychiatric conditions, such as schizophrenia, bipolar disorder, or treatment-resistant depression, for which Abilify is approved
- The side effect profile of Abilify, including weight gain, metabolic changes, and movement disorders, which makes it less suitable as a first choice for hoarding without other psychiatric indications
- The importance of cognitive-behavioral therapy (CBT) in treating hoarding disorder, which can help individuals identify and change negative thought patterns and behaviors associated with hoarding.
From the Research
Effectiveness of Abilify for Hoarding Disorder
- There are no direct studies on the effectiveness of Abilify (aripiprazole) for treating hoarding disorder in the provided evidence.
- However, studies have investigated the use of other medications, such as selective serotonin reuptake inhibitors (SRIs) and venlafaxine extended-release, in treating hoarding disorder 2, 3, 4.
- These studies suggest that SRIs and venlafaxine extended-release may be effective in reducing hoarding symptoms, with response rates similar to those seen in non-hoarding obsessive-compulsive disorder patients 2, 3, 4.
- Cognitive-behavioral therapy (CBT) with exposure and response prevention is also considered a potentially effective treatment for hoarding disorder, although it may need to be specialized and modified for this specific condition 5, 6.
- Factors such as avoidant coping, motivation for change, and readiness for change may influence treatment outcome and attrition in adults with hoarding disorder 6.