Cariprazine for the treatment of bipolar depression: a review

ABSTRACT

Introduction: Depressive symptoms and episodes dominate the course of bipolar disorder. The morbidity of bipolar disorder is disproportionately mediated by depressive symptoms; economic costs of bipolar disorder are also disproportionately due to unremitting depressive symptoms. Relatively few treatment options have established unequivocal efficacy in the treatment of bipolar depression. Herein we review evidence regarding the efficacy of the D₃ preferring D₂/D₃ partial agonist cariprazine in the treatment of adults with bipolar depression.

Areas covered: Randomized controlled trials that sought to determine the efficacy, tolerability, and safety of cariprazine in adults with bipolar I depression.

Expert opinion: The available evidence from clinical trials indicates that cariprazine is effective at treating bipolar depression wherein treatment for bipolar depression remains an unmet need in bipolar disorder. Cariprazine has demonstrated good tolerability and safety profiles in bipolar disorder. Furthermore, cariprazine may be effective in improving both anhedonia and cognitive dysfunction. Long term prevention studies in bipolar depression, as well as separate studies evaluating efficacy in adults with bipolar II depression, are needed.

KEYWORDS:

• Bipolar depression
• bipolar disorder
• cariprazine
• D₂/D₃ partial agonist
• pharmacotherapy

Declaration of interest

RS McIntyre has the following disclosures: During the past two years, RS McIntyre has received fees for speaking/consultation from the following pharmaceutical companies: Shire, Purdue, Otsuka, Janssen-Ortho, Lundbeck, Pfizer, Neurocrine, Neuralstem, Sunovion, Takeda, Allergan. During the past two years, RS McIntyre has received research support from: Lundbeck, Shire, Purdue, Allergan. RS McIntyre has also received research grants from Stanley Medical Research Institute. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose

Additional information

Funding

This paper was not funded