Abstract

Despite the emergence of a large number of new antipsychotics in recent decades, the therapy of schizophrenia, especially its paranoid form, remains a difficult and urgent task for practicing psychiatrists. This is primarily due to the complexity and often polymorphism of the clinical picture of the disease, the predominance in the structure of one or several characteristic symptom complexes – hallucinatory-paranoid, affective-delusional, senesto-hypochondriacal. The onset of paranoid schizophrenia at a young age makes it difficult to select a drug for therapy, which, along with a pronounced antipsychotic effect, a positive effect on both productive and negative symptoms, should have good tolerability in general and a favorable neuroendocrine profile, which will minimize the risk of the patient refusing therapy and maintain his social and labor functioning. As well as the therapy of elderly patients and patients with comorbid neurological, cardiovascular, and endocrine diseases, it also requires careful selection of the drug, taking into account its possible adverse effects and effects on the course of concomitant diseases. We present a number of clinical observations that demonstrate the effectiveness of the third–generation antipsychotic cariprazine – as a powerful antipsychotic drug with a favorable safety profile, providing high adherence to therapy and successfully used both in young patients with a complex clinical picture of paranoid schizophrenia, including those resistant to psychopharmacotherapy, and in patients with poor tolerability of drugs of various groups and the presence of concomitant somatic pathology.

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