Coentre Ricardo, Saraiva Rodrigo, Sereijo Carolina, Levy Pedro
PROFIP-Programa de Intervenção nas Fases Iniciais da Psicose, Department of Psychiatry, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.
Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
Front Psychiatry. 2021 Dec 16;12:788281. doi: 10.3389/fpsyt.2021.788281. eCollection 2021.
Cariprazine is a new atypical antipsychotic approved for the acute and maintenance treatment of schizophrenia (1, 2) and for the treatment of manic or mixed episodes associated with bipolar I disorder (1). Recently, cariprazine also got extended FDA-approval for the treatment of depressive episodes in adults with bipolar I disorder (3). The use of low doses of atypical antipsychotics is an essential component of early intervention in psychosis. For its particular performance and tolerability, cariprazine is becoming an important option for the treatment of first-episode psychosis. Three patients experiencing first-episode psychosis (FEP) were successfully treated with cariprazine. Two patients were in their first months of the disease, and the third patient was in his third year after the FEP. The three patients had a diagnosis of non-affective FEP, which includes schizophrenia, delusional disorder, and schizoaffective disorder. One of them was in their third year after the FEP with a predominance of negative symptoms at this stage of the disorder. All the patients were treated with cariprazine with a target dose of 3-4.5 mg/day. The three patients showed improvements in their psychosis, including a decrease in negative symptoms. No significant side effects were reported. Our three case reports indicate that cariprazine is an atypical antipsychotic beneficial in the treatment of early psychosis. Treatment with low doses of cariprazine could be effective and tolerable in this phase of the disorder. Future studies with longer follow-up of FEP patients are recommended to confirm these positive results of cariprazine in the early phases of psychosis.
卡立哌嗪是一种新型非典型抗精神病药物，已被批准用于精神分裂症的急性和维持治疗（1,2）以及用于治疗与双相I型障碍相关的躁狂或混合发作（1）。最近，卡立哌嗪还获得了美国食品药品监督管理局（FDA）的扩大批准，用于治疗双相I型障碍成人患者的抑郁发作（3）。使用低剂量非典型抗精神病药物是精神病早期干预的重要组成部分。由于其特殊的性能和耐受性，卡立哌嗪正成为治疗首发精神病的重要选择。三名首发精神病（FEP）患者用卡立哌嗪成功治疗。两名患者处于疾病的最初几个月，第三名患者处于首发精神病后的第三年。这三名患者被诊断为非情感性首发精神病，包括精神分裂症、妄想性障碍和精神分裂情感性障碍。其中一名患者在首发精神病后的第三年，在此疾病阶段以阴性症状为主。所有患者均接受卡立哌嗪治疗，目标剂量为3 - 4.5毫克/天。这三名患者的精神病症状有所改善，包括阴性症状减少。未报告明显副作用。我们的三个病例报告表明，卡立哌嗪是一种对早期精神病治疗有益的非典型抗精神病药物。在疾病的这个阶段，低剂量卡立哌嗪治疗可能有效且耐受性良好。建议对首发精神病患者进行更长时间随访的未来研究，以证实卡立哌嗪在精神病早期阶段的这些积极结果。
