New developments in the management of schizophrenia and bipolar disorder: potential use of cariprazine

Abstract

Cariprazine is a recently developed antipsychotic drug with a partial agonism for the D₂ and D₃ receptors. It shows a tenfold greater affinity for the D₃ receptor. In clinical trials, its therapeutic effect has been tested in patients with an acute exacerbation of schizophrenia and in patients with acute mania in bipolar disorder. Like risperidone, cariprazine improves positive and negative schizophrenic symptoms, and ameliorates cognitive functions. Cariprazine induces extrapyramidal symptoms less often than risperidone and can cause acute akathisia. It is a prolactin-sparing antipsychotic drug and has a favorable metabolic profile. In acute mania in bipolar disorder, it treats manic symptoms significantly better than placebo. As a consequence of its improved adverse effects, cariprazine improves patients’ quality of life to a greater extent than other second-generation antipsychotic drugs. Cariprazine is a promising antipsychotic drug in the treatment of schizophrenia, acute mania in bipolar disorder, and in schizophrenia with mania. In these patients, its long-term therapeutic effect and its action in comparison with other second-generation antipsychotic drugs, above all aripiprazole, remain to be tested in clinical trials.

Keywords:

• cariprazine
• second-generation antipsychotic drug
• schizophrenia
• acute mania
• D₂ receptor
• D₃ receptor
• partial agonism
• akathisia
• metabolic parameters
• cognitive function

Acknowledgments

The authors wish to thank Mr Nicholas Skinner (University of Salamanca, Spain) for supervising the English text.

Disclosure

The authors report no conflicts of interest in this work.