The effectiveness and safety of cariprazine in schizophrenia patients with negative symptoms and insufficient effectiveness of previous antipsychotic therapy: an observational study

Abstract

The aim of the study was to examine the effectiveness and safety of cariprazine in routine psychiatric settings on schizophrenia patients with negative symptoms who have been treated with antipsychotics previously but without sufficient success. This was an open-label, flexible-dose, 16-week, observational study in Latvia. The primary outcome measure was an array of anamnesisbased clinical questions on schizophrenia symptoms rated on a seven-point scale. Other outcome measurements were the clinical global impression improvement (CGI-I) and severity (CGI-S) scales. Safety parameters included spontaneous reports of adverse events and specific assessments of extrapyramidal side-effects. A mixed model for repeated measures was fit to the data to evaluate the mean change from baseline for all visits. A total of 116 patients enrolled in the study (completion: 83%). Change from baseline to termination in symptom control was statistically significant (−7.3; P < 0.001), with the most improvement in negative symptoms (−6.3; P < 0.001). Over 70% of patients improved minimally or much based on the CGI-I scores at the final visit, and the CGI-S scores indicated an overall improvement in severity from moderately to mildly ill. 40% of patients experienced treatment-emergent adverse events. Over 70% of doctors were satisfied with the effectiveness and tolerability of cariprazine. Cariprazine significantly improved negative symptoms in schizophrenia patients.

Addressing negative symptoms of schizophrenia pharmacologically with cariprazine: evidence from clinical trials, a real-world study, and clinical cases

“…Similar results were acquired in the Latvian observational study as well, where about 40% of patients had at least one TEAE; most commonly akathisia (13%), anxiety (10%) or parkinsonism (6%) [12]. Nonetheless, the physicians overall impression about tolerability was highly positive: 45% were very satisfied and 39% were satisfied with cariprazine [12].…”

“…In addition, a real-world study has also confirmed the results of the Nemeth et al trial recently [10]. A 16-week, open-label observation study conducted in Latvia found support for the notion that cariprazine has the ability to improve negative symptoms in schizophrenia patients with predominant negative symptoms who have been treated with antipsychotics previously but without sufficient response [12]. In this trial significant improvement in the five domains of negative symptoms were detected from week 2 onwards [12].…”

“…A 16-week, open-label observation study conducted in Latvia found support for the notion that cariprazine has the ability to improve negative symptoms in schizophrenia patients with predominant negative symptoms who have been treated with antipsychotics previously but without sufficient response [12]. In this trial significant improvement in the five domains of negative symptoms were detected from week 2 onwards [12]. Furthermore, the severity of the disorder according to the Clinical Global Impression -Severity (CGI-S) scale changed from moderately to mildly ill [12].…”

“…Furthermore, the severity of the disorder according to the Clinical Global Impression -Severity (CGI-S) scale changed from moderately to mildly ill [12]. Due to these results, over 70% of the physicians reported to be either 'satisfied' or 'very satisfied' with the effectiveness of cariprazine [12].…”

Treatment of Symptom Clusters in Schizophrenia, Bipolar Disorder and Major Depressive Disorder With the Dopamine D3/D2 Preferring Partial Agonist Cariprazine

“…Cariprazine was also found to be uniquely effective in treating primary negative symptoms of schizophrenia, due to its predominant preference for D3 receptors, as well as its considerable affinity for 5-HT 1A receptors (33)(34)(35)(36)(37). In a randomized, double-blind multicenter study which compared the efficacy of cariprazine and risperidone in patients with schizophrenia with predominantly negative symptoms, cariprazine in the mean dose of 4.2 mg/d showed a superiority over risperidone (mean dose 3.8 mg/d) at Week 14, which was continued until Week 26 (end of trial) (33).…”