Abstract
Cariprazine is a dopamine D3 preferring D3/D2 receptor partial agonist antipsychotic indicated for the treatment of schizophrenia and bipolar disorders. Efficacy has been proven in randomized controlled studies, and the main indications are predominant negative symptoms in schizophrenia associated with the D3-receptor binding. Main side effects are akathisia, insomnia, and constipation. Compared with other antipsychotics, little effects on metabolic and cardiovascular parameters have been reported.
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References
Ágai-Csongor É, Domány G, Nógrádi K, et al. Discovery of cariprazine (RGH-188): a novel antipsychotic acting on dopamine D3/D2 receptors. Bioorg Med Chem Lett. 2012;22:3437–40.
Barabássy A, Sebe B, Acsai K, et al. Safety and tolerability of cariprazine in patients with schizophrenia: a pooled analysis of eight phase II/III studies. Neuropsychiatr Dis Treat. 2021;17:957–70.
Barth V, Need AB, Tzavara ET, et al. In vivo occupancy of dopamine D3 receptors by antagonists produces neurochemical and behavioral effects of potential relevance to attention-deficit-hyperactivity disorder. J Pharmacol Exp Ther. 2013;344:501–10.
Bouthenet ML, Souil E, Martres MP, et al. Localization of dopamine D3 receptor mRNA in the rat brain using in situ hybridization histochemistry: comparison with dopamine D2 receptor mRNA. Brain Res. 1991;564:203–21.
Calabrese JR, Keck PE Jr, Starace A, et al. Efficacy and safety of low-and high-dose cariprazine in acute and mixed mania associated with bipolar I disorder: a double-blind, placebo-controlled study. J Clin Psychiatry. 2015;76:284–92.
Citrome L. Cariprazine: chemistry, pharmacodynamics, pharmacokinetics, and metabolism, clinical efficacy, safety, and tolerability. Expert Opin Drug Metab Toxicol. 2013a;9:193–206.
Citrome L. Cariprazine in schizophrenia: clinical efficacy, tolerability, and place in therapy. Adv Therap. 2013b;30:114–26.
Cutler AJ, Durgam S, Wang Y, et al. Evaluation of the long-term safety and tolerability of cariprazine in patients with schizophrenia: results from a 1-year open-label study. CNS Spectr. 2018;23:39–50.
Durgam S, Starace A, Li D, et al. An evaluation of the safety and efficacy of cariprazine in patients with acute exacerbation of schizophrenia: a phase II, randomized clinical trial. Schizophr Res. 2014;152:450–7.
Durgam S, Starace A, Li D, et al. The efficacy and tolerability of cariprazine in acute mania associated with bipolar I disorder: a phase II trial. Bipolar Disord. 2015a;17:63–75.
Durgam S, Cutler AJ, Lu K, et al. Cariprazine in acute exacerbation of schizophrenia: a fixed-dose, phase 3, randomized, double-blind, placebo- and active-controlled trial. J Clin Psychiatry. 2015b;76:e1574–82.
Durgam S, Earley W, Li R, et al. Long-term cariprazine treatment for the prevention of relapse in patients with schizophrenia: a randomized, double-blind, placebo-controlled trial. Schizophr Res. 2016a;176:264–71.
Durgam S, Earley W, Lipschitz A, et al. An 8-week randomized, double-blind, placebo-controlled evaluation of the safety and efficacy of cariprazine in patients with bipolar I depression. Am J Psychiatry. 2016b;173:271–81.
Durgam S, Earley W, Lu K, Németh G, Laszlovszky I, Volk S, Litman RE. Global improvement with cariprazine in the treatment of bipolar I disorder and schizophrenia: a pooled post hoc analysis. Int J Clin Pract. 2017;71:e13037. https://doi.org/10.1111/ijcp.13037.
Edinoff A, Ruoff M, Ghaffar Y, et al. Cariprazine to treat schizophrenia and bipolar disorder in adults. Psychopharmacol Bull. 2020;50:83–117.
El-Mallakh RS, Elmaadawi AZ, Gao Y, Lohano K, Roberts RJ. Current and emerging therapies for the management of bipolar disorders. J Cent Nerv System Disord. 2011;3:189–97.
Fagiolini A, Alcalá JÁ, Aubel T, et al. Treating schizophrenia with cariprazine: from clinical research to clinical practice. Real world experiences and recommendations from an international panel. Ann General Psychiatry. 2020;19:55. https://doi.org/10.1186/s12991-020-00305-3.
Fleischhacker W, Galderisi S, Laszlovszky I, et al. The efficacy of cariprazine in negative symptoms of schizophrenia: post hoc analyses of PANSS individual items and PANSS-derived factors. Eur Psychiatry. 2019;58:1–9.
Garnock-Jones KP. Cariprazine: a review in schizophrenia. CNS Drugs. 2017;31:513–25.
Horacek J, Bubenikova-Valesova V, Kopecek M, et al. Mechanism of action of atypical antipsychotic drugs and the neurobiology of schizophrenia. CNS Drugs. 2006;20:389–409.
Kane JM, Zukin S, Wang Y, et al. Efficacy and safety of cariprazine in acute exacerbation of schizophrenia: results from an international, phase III clinical trial. J Clin Psychopharmacol. 2015;35:367–73.
Kapur S, Remington G, Jones C, et al. High levels of dopamine D-2 receptor occupancy with low-dose haloperidol treatment: a PET study. Am J Psychiatry. 1996;153:948–50.
Kapur S, Zipursky R, Roy P, et al. The relationship between D2 receptor occupancy and plasma levels on low dose oral haloperidol: a PET study. Psychopharmacology. 1997;131:148–52.
Kirschner N, Gémesi LI, Vastag M, et al. In vitro metabolism of RGH-188. Presented at the 10th European International Society of the Study of Xenobiotics (ISSX), Meeting; May 18–21, 2008. Available from: https://issx.confex.com/issx/10euro/webprogram/Paper8686.html. Accessed 30 Sept 2015.
Kiss B, Horváth A, Némethy Z, et al. Cariprazine (RGH-188), a dopamine D3 receptor-preferring, D3/D2 dopamine receptor antagonist-partial agonist antipsychotic candidate: in vitro and neurochemical profile. J Pharmacol Exp Therap. 2010;333:328–40.
Lao K, He Y, Wong I, Besag F, Chan E. Tolerability and safety profile of cariprazine in treating psychotic disorders, bipolar disorder and major depressive disorder: a systematic review with meta-analysis of randomized controlled trials. CNS Drugs. 2016;30:1043–54. https://doi.org/10.1007/s40263-016-0382-z.
Laszlovszky I, Barabassy A, Nemeth G. Cariprazine, a broad-spectrum antipsychotic for the treatment of schizophrenia: pharmacology, efficacy, and safety. Adv Ther. 2021;38:3652–73.
Madras BK. History of the discovery of the antipsychotic dopamine D2 receptor: a basis for the dopamine hypothesis of schizophrenia. J Hist Neurosci. 2013;22:62–78.
Mészáros GP, Kapás M, Borsos M, et al. (P.3.c.047) Pharmacokinetics of RGH-188, a new dopamine D3/D2 antagonist/partial agonist atypical antipsychotic, in healthy subjects. Eur Neuropsychopharmacol. 2007;17(Suppl 4):S451–2.
Nasrallah H, Earley W, Cutler A, Wang Y, Lu K, Laszlovszky I, Németh G, Durgam S. The safety and tolerability of cariprazine in long-term treatment of schizophrenia: a post hoc pooled analysis. BMC Psychiatry. 2017;24(17):305. https://doi.org/10.1186/s12888-017-1459-z.
Németh G, István Laszlovszky I, Pál Czobor P, et al. Cariprazine versus risperidone monotherapy for treatment of predominant negative symptoms in patients with schizophrenia: a randomised, double-blind, controlled trial. Lancet. 2017;389:1103–13.
Newman-Tacredi A. The importance of 5HT1A receptor agonism in antipsychotic drug action: rationale and perspectives. Curr Opin Investig Drugs. 2010;11:802–12.
Nordström AL, Farde L, Wiesel FA, et al. Central D2-dopamine receptor occupancy in relation to antipsychotic drug effects – a double-blind PET study of schizophrenic-patients. Biol Psychiatry. 1993;33:227–35.
Papp M, Gruca P, Lasoń-Tyburkiewicz M, Adham N, Kiss B, Gyertyán I. Attenuation of anhedonia by cariprazine in the chronic mild stress model of depression. Behav Pharmacol. 2014;25:567–74.
Pásztor Mészáros G, Agai-Csongor E, Kapaś M. Sensitive LC-MS/MS methods for the quantification of RGH-188 and its active metabolites, desmethyl- and didesmethyl-cariprazine in human plasma and urine. J Pharm Biomed Anal. 2008;48:388–97.
Patel M, Jain R, Tohen M, et al. Efficacy of cariprazine in bipolar I depression across patient characteristics: a post hoc analysis of pooled randomized, placebo-controlled studies. Int Clin Psychopharmacol. 2021;36:76–83.
Potkin S, Keator D, Mukherjee J, et al. (P.1.e.028) Dopamine D3 and D2 receptor occupancy of cariprazine in schizophrenic patients. Eur Neuropsychopharmacol. 2009;19(Suppl 3):S316.
Roberts RJ, Findlay LJ, El-Mallakh PL, El-Mallakh RS. Update on schizophrenia and bipolar disorder: focus on cariprazine. Neuropsychiatr Dis Treatt. 2016;12:1837–42.
Sachs GS, Greenberg WM, Starace A, et al. Cariprazine in the treatment of acute mania in bipolar I disorder: a double-blind, placebo-controlled, Phase III trial. J Affect Disord. 2015;174:296–302.
Seeman P. Atypical antipsychotics: mechanism of action. Can J Psychiatr. 2002;47:27–38.
Seneca N, Finnema SJ, Laszlovszky I, et al. Occupancy of dopamine D2 and D3 and serotonin 5-HT1A receptors by the novel antipsychotic drug candidate, cariprazine (RGH-188), in monkey brain measured using positron emission tomography. Psychopharmacology. 2011;218:579–87.
Sheynikhovich D, Otani S, Arleo A. The role of tonic and phasic dopamine for long-term synaptic plasticity in the prefrontal cortex: a computational model. J Physiol Paris. 2011;105(1–3):45–52.
Sokoloff P, Giros B, Martres MP, Bouthenet ML, Schwartz J. Molecular cloning and characterization of a novel dopamine receptor (D3) as a target for neuroleptics. Nature. 1990;347:146–51.
Sokoloff P, Diaz J, Levesque D, et al. Novel dopamine receptor subtypes as targets for antipsychotic drugs. Ann N Y Acad Sci. 1995;757:278–92.
Tohen M. Cariprazine as a treatment option for depressive episodes associated with bipolar 1 disorder in adults: an evidence-based review of recent data. Drug Des Devel Ther. 2021;15:2005–12.
Zhao M, Qin B, Wang J, Zhang Y, Zhao J, Mao Y, Zhang X, Zhang R. Efficacy and acceptability of cariprazine in acute exacerbation of schizophrenia: meta-analysis of randomized placebo-controlled trials. J Clin Psychopharmacol. 2018;38:55–9. https://doi.org/10.1097/JCP.0000000000000834.
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Schönknecht, P. (2022). Cariprazine in the Treatment of Psychosis. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-030-62059-2_118
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DOI: https://doi.org/10.1007/978-3-030-62059-2_118
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