RT Journal Article
T1 Treating schizophrenia with cariprazine: from clinical research to clinical practice. Real world experiences and recommendations from an International Panel.
A1 Fagiolini, Andrea
A1 Alcalá, José Ángel
A1 Aubel, Thomas
A1 Bienkiewicz, Wojciech
A1 Bogren, Mats Magnus Knut
A1 Gago, Joaquim
A1 Cerveri, Giancarlo
A1 Colla, Michael
A1 Sanchez, Francisco Collazos
A1 Cuomo, Alessandro
A1 Helge, Frieling
A1 Iacoponi, Eduardo
A1 Karlsson, Per-Axel
A1 Peddu, Pradeep
A1 Pettorruso, Mauro
A1 Pereira, Henrique Jorge Ramos
A1 Schölin, Johan Sahlsten
A1 Vernaleken, Ingo Bernd
K1 Antipsychotics
K1 Cariprazine
K1 Negative symptoms
K1 Patient subgroups
K1 Recommendations
K1 Schizophrenia
AB Management of schizophrenia is sub-optimal in many patients. Targeting negative symptoms, among the most debilitating aspects of schizophrenia, together with positive symptoms, can result in significant functional benefits and dramatically improve quality of life for patients and their carers. Cariprazine, a partial agonist of the dopamine receptors D2/D3 has demonstrated effectiveness across symptom domains in clinical trials, particularly on negative symptoms. To obtain a broader insight from clinicians with specific experience with cariprazine, on how it affects patient populations outside the clinical trial setting. The panel addressed a series of psychopharmacologic topics not comprehensively addressed by the evidence-based literature, including characteristics of patients treated, dosing and switching strategies, duration of therapy, role of concomitant medications and tolerability as well as recommendations on how to individualize cariprazine treatment for patients with schizophrenia. Patients recommended for cariprazine treatment are those with first episodes of psychosis, predominant negative symptoms (maintenance/acute phase) and significant side effects (metabolic side effects, hyperprolactinemia, sedation) with other antipsychotics. When the long-term treatment of a lifetime illness is adequately weighted, cariprazine becomes one of the first-line medications, not only for patients with predominant negative symptoms but also for those with relatively severe positive symptoms, especially if they are at the first episodes and if a specific medication is added for symptoms such as agitation or insomnia. For instance, patients with agitation may also benefit from the combination of cariprazine and a benzodiazepine or another sedating agent. Cariprazine may be prescribed as add-on to medications such as clozapine, when that medication alone is ineffective for negative symptoms, and sometimes the first may be discontinued or its dose lowered, after a period of stability, leaving the patient on a better tolerated antipsychotic regimen. Based on real-world clinical experience, the panel considered that cariprazine, with its distinct advantages including pharmacokinetics/pharmacodynamics, good efficacy and tolerability, represents a drug of choice in the long-term management of schizophrenia not only for patients with predominant negative symptoms but also for those with positive symptoms.
SN 1744-859X
YR 2020
FD 2020-09-26
LK https://hdl.handle.net/10668/25171
UL https://hdl.handle.net/10668/25171
LA en
DS RISalud
RD Apr 9, 2025