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Tijdschrift voor Psychiatrie 61 (2019) 10, 702 - 709

Review article

Cariprazine for acute and maintenance treatment of schizophrenia

S.K. Spoelstra, L. Visser, H. Knegtering

background Since 2018, cariprazine has been available for the treatment of schizophrenia on the Dutch and Belgian markets.
aim To give an overview of the indications, effectiveness and side effects of cariprazine. To make an inventory of the advantages and disadvantages of this new antipsychotic drug.
method A clinically oriented literature review of published clinical studies and pharmacodynamic and -kinetic publications.
results Cariprazine is unique because of its preferential D3 receptor partial agonist affinity and has, in theory, a beneficial effect on negative symptoms. The antipsychotic has two active metabolites: desmethylcariprazine and didesmethylcariprazine. The long half-life of cariprazine indicates that, in theory, the drug should not be given daily. Cariprazine is metabolized by cyp3a4 and to a lesser extent by cyp2d6 enzymes. Extrapyramidal symptoms and akathisia are relatively frequent side effects. In contrast, metabolic side effects and weight gain have been reported rarely.
conclusion Cariprazine can be an effective treatment option for schizophrenia. The final positioning of this antipsychotic drug will have to be based on future research.

keywords antipsychotics, cariprazine, partial dopamine agonist, schizophrenia