Do André, Keramatian Kamyar, Schaffer Ayal, Yatham Lakshmi
Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Front Psychiatry. 2021 Dec 14;12:769897. doi: 10.3389/fpsyt.2021.769897. eCollection 2021.
Bipolar disorder (BD) is chronic psychiatric disorder associated with significant impairment in psychosocial functioning and quality of life. Although current pharmacological treatments for BD have improved its clinical management, many patients do not achieve remission, particularly those suffering from bipolar depression. In addition, available treatments are associated with a myriad of potential adverse effects, which highlights the need for novel therapeutic agents that can be effective for both phases of the illness with a reduced side effect burden. Cariprazine is a novel antipsychotic that is a dopamine D2/D3 partial agonist with a preference for D3 receptors. In this review, we examine the pharmacological properties, clinical efficacy and tolerability profile of cariprazine in patients with BD, taking into account the latest clinical trials data. We also review analyses addressing clinically relevant subgroups and symptom domains in BD. Current evidence suggests efficacy for cariprazine 3-12 mg/day in the treatment of acute manic and mixed episodes; for bipolar depression, the efficacy of cariprazine appears to be dose-related, with doses of 1.5-3 mg/day beneficial as monotherapy. Cariprazine is overall well-tolerated by patients in both manic and depressive episodes. Its most common side effects relative to placebo include akathisia, extrapyramidal symptoms and nausea. There are no metabolic concerns reported with cariprazine use. In summary, the latest evidence suggests that cariprazine is an effective and safe treatment option for BD.
双相情感障碍（BD）是一种慢性精神疾病，会对心理社会功能和生活质量造成严重损害。尽管目前用于BD的药物治疗改善了其临床管理，但许多患者并未实现缓解，尤其是那些患有双相抑郁的患者。此外，现有治疗方法存在众多潜在不良反应，这凸显了对新型治疗药物的需求，这类药物应对疾病的两个阶段均有效且副作用负担更小。卡立普嗪是一种新型抗精神病药物，是一种多巴胺D2/D3部分激动剂，对D3受体具有偏好性。在本综述中，我们结合最新临床试验数据，研究了卡立普嗪在BD患者中的药理特性、临床疗效和耐受性。我们还回顾了针对BD临床相关亚组和症状领域的分析。目前的证据表明，卡立普嗪3 - 12毫克/天在治疗急性躁狂和混合发作方面有效；对于双相抑郁，卡立普嗪的疗效似乎与剂量相关，1.5 - 3毫克/天作为单一疗法有益。在躁狂和抑郁发作中，患者对卡立普嗪总体耐受性良好。与安慰剂相比，其最常见的副作用包括静坐不能、锥体外系症状和恶心。使用卡立普嗪未报告有代谢方面的问题。总之，最新证据表明卡立普嗪是BD一种有效且安全的治疗选择。
