Cariprazine: A Review in Schizophrenia
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Cariprazine (Vraylar™) is a dopamine D3-preferring D2/D3 receptor partial agonist indicated for the treatment of patients with schizophrenia. This narrative review summarizes pharmacological, efficacy and tolerability data relevant to the use of cariprazine in patients with this disorder. In 6-week, phase IIb and III trials in patients with schizophrenia, cariprazine was significantly more efficacious than placebo in improving schizophrenia symptoms, including improvements in Positive and Negative Syndrome Scale (PANSS) total scores. It was associated with a significantly longer time to relapse than placebo in a long-term, phase III, relapse-prevention study. Cariprazine was also significantly more efficacious than risperidone in improving PANSS Factor Score for Negative Symptoms in a phase III trial in patients with predominantly negative symptoms of schizophrenia, a typically difficult to treat group of patients. Cariprazine was generally well tolerated in clinical trials, with most adverse events being of mild to moderate severity, and metabolic changes observed were considered generally not clinically significant. Cariprazine is a useful addition to the treatment options for schizophrenia, and may be of particular use in patients with predominantly negative symptoms.
During the peer review process, the manufacturer of cariprazine was also offered an opportunity to review this article. Any changes resulting from comments received were made on the basis of scientific and editorial merit.
Compliance with Ethical Standards
The preparation of this review was not supported by any external funding.
Conflict of interest
Karly Garnock-Jones is a salaried employee of Adis/Springer, is responsible for the article content and declares no relevant conflicts of interest.
Additional information about this Adis Drug Review can be found at http://www.medengine.com/Redeem/AB48F06045A02576.
- 1.National Institute for Health and Care Excellence. Psychosis and schizophrenia in adults: prevention and management (CG178). 2014. http://www.nice.org.uk/. Accessed 28 Apr 2017.
- 3.Lehman AF, Lieberman JA, Dixon LB, et al. American Psychiatric Association practice guideline for the treatment of patients with schizophrenia. 2nd ed. 2010. https://psychiatryonline.org/. Accessed 28 Apr 2017.
- 6.Actavis Pharma Inc. Vraylar™ (cariprazine) capsules: US prescribing information. 2017. http://www.allergan.com/. Accessed 28 Apr 2017.
- 9.Kiss B, Némethy Z, Laszlovszky I, et al. Pharmacological characteristics of major human metabolites of cariprazine [abstract no. P8-062]. In: 169th annual meeting of the American Psychiatric Association. 2016.Google Scholar
- 18.Castner SA, Abbott AL, Adham N, et al. Subchronic treatment with the partial dopamine agonist cariprazine protects against ketamine-induced cognitive deficits in a nonhuman primate model relevant to schizophrenia [abstract no. M28]. Neuropsychopharmacology. 2014;39(Suppl):S129.Google Scholar
- 19.Periclou A, Phillips L, Bihorel S, et al. Characterization of population pharmacokinetics of cariprazine and its major metabolites [abstract no. 104]. In: 169th annual meeting of the American Psychiatric Association. 2016.Google Scholar
- 21.Carrothers T, Willavize S, Jaworowicz D, et al. Relationship of cariprazine plasma concentration to efficacy and safety in patients with schizophrenia or bipolar mania [abstract no. P6-014]. In: 169th annual meeting of the American Psychiatric Association. 2016.Google Scholar
- 28.Fleischhacker W, Marder S, Lu K, et al. Efficacy of cariprazine vs. placebo across schizophrenia symptom domains: pooled analyses from 3 phase II/III trials [abstract no. T93]. Neuropsychopharmacology. 2014;39(Suppl):S351–2.Google Scholar
- 29.Durgam S, Laszlovszky I, Nagy K, et al. Categorical improvements in severity of mania and schizophrenia symptoms: pooled analyses of cariprazine phase II/III trials [abstract no. P-03-014]. Int J Neuropsychopharmacol. 2014;17(Suppl 1):54.Google Scholar
- 32.Earley W, Durgam S, Debelle M, et al. Cariprazine for negative symptoms of schizophrenia: pooled post hoc analysis of 2 randomized, double-blind, placebo-and active-controlled trials [abstract no. M204]. Neuropsychopharmacology. 2015;40(Suppl):S233–4.Google Scholar
- 33.Debelle M, Kahn R, Laszlovszky I, et al. Cariprazine as monotherapy for the treatment of predominant negative symptoms of patients with schizophrenia: a double-blind, active comparator-controlled trial [abstract no. M206]. Neuropsychopharmacology. 2015;40(Suppl):S235–6.Google Scholar
- 37.Marder S, Zukin S, Lu K, et al. Metabolic safety of cariprazine in patients with schizophrenia [abstract no. M156]. Neuropsychopharmacology. 2015;40(Suppl):S205.Google Scholar