Cariprazine

Abstract

Abstract Objective Cariprazine is a new antipsychotic drug approved for the treatment of schizophrenia in Europe in 2017. Clinical studies suggest advantages of cariprazine in comparison to other antipsychotic agents regarding therapeutic effects on “negative symptoms”, antipsychotic-induced weight gain and increased serum prolactin levels. Akathisia was reported to be one of the most common side effects. Currently, however, data from naturalistic treatment settings regarding the efficacy, safety and tolerability of cariprazine are missing. Thus, we report and discuss our clinical experiences with cariprazine regarding efficacy, safety and tolerability in order to provide first treatment data from a naturalistic treatment setting. Material and methods The course of treatment of a series of 3 patients with schizophrenia spectrum disorders and treatment with cariprazine (mono- or combined therapy) is presented and discussed. Results Cariprazine demonstrated sufficient antipsychotic effects in 2 out of 3 cases; however, in 2 out of 3 cases treatment had to be discontinued due to akathisia/agitation; in 1 case, cariprazine monotherapy facilitated successful normalization of elevated prolactin serum levels (due to combined treatment with risperidone and olanzapine). Conclusion(s): In general, experience with cariprazine within a naturalistic treatment setting is in accordance with data from clinical studies, particularly concerning effects on “negative symptoms”, antipsychotic-associated elevation of prolactin serum levels and risk of akathisia. The comparatively high incidence of discontinuation of cariprazine due to akathisia/agitation in our case series may be an effect of polypharmacy which was very common among our three cases. Clinical relevance This case series provides some evidence that safety, tolerability and antipsychotic efficacy of cariprazine in naturalistic treatment settings may be similar to findings from the available clinical studies.