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Cariprazine: A Review in Schizophrenia

Abstract

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.

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Acknowledgements

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.

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Correspondence to Karly P. Garnock-Jones.

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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.

Additional information

The manuscript was reviewed by: E. Brandl, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany; J. M. Davis, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA; M. C. Mauri, Department of Neuroscience and Mental Health, IRCCS Ospedale Maggiore Policlinico, Milan, Italy; H. A. Nasrallah, Department of Psychiatry and Behavioural Neuroscience, Saint Louis University School of Medicine, St Louis, MO, USA; M. H. Rapaport, Department of Psychiatry and Behavioural Sciences, Emory University School of Medicine, Atlanta, GA, USA; G. Sani, NESMOS Department, Sapienza University, Rome, Italy; J. Volavka, Department of Psychiatry, New York University School of Medicine, Big Sky, MT, USA.

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Garnock-Jones, K.P. Cariprazine: A Review in Schizophrenia. CNS Drugs 31, 513–525 (2017). https://doi.org/10.1007/s40263-017-0442-z

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