Department of Mental Health, Faculty of Medical Sciences of Santa Casa de São Paulo, São Paulo, Brazil.
Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
Int J Psychiatry Clin Pract. 2023 Mar;27(1):107-109. doi: 10.1080/13651501.2022.2071740. Epub 2022 May 11.
Early treatment of psychotic illness improves outcomes, reduces relapse rates and should not be delayed. Cariprazine is a promising antipsychotic drug and may be a valuable resource when clinicians are in doubt if psychotic symptoms are due to schizophrenia or bipolar disorder.
We conducted a systematic review and meta-analysis that included seven studies (n = 2896) analyzing the effect of cariprazine in psychotic symptoms assessed by the positive and negative symptoms scale (PANSS).
We found cariprazine to be significantly superior to placebo (Hedges' g = 0.40; 95% CI 0.32-0.49) for acute psychosis independently of primary psychiatric diagnosis and also to be superior to placebo for both schizophrenia (Hedges' g = 0.39; 95% CI 0.29-0.50) and bipolar patients (Hedges' g = 0.43; 95% CI 0.27-0.58).
We propose that cariprazine may be useful in treating psychosis independently of nosological differentiation at the beginning of the treatment Key pointsEarly treatment of psychotic illness with antipsychotic medications improves outcomes and reduces relapse rates.Cariprazine was found to be significantly superior to placebo for acute psychosis independently of primary psychiatric diagnosis.Cariprazine may be useful in treating psychosis independently of nosological differentiation between schizophrenia and bipolar disorder at the beginning of the treatment.
早期治疗精神病可改善预后、降低复发率,不应延误。卡利拉嗪是一种有前途的抗精神病药物,当临床医生怀疑精神病症状是由精神分裂症还是双相情感障碍引起时,它可能是一种有价值的资源。
我们进行了一项系统评价和荟萃分析,包括 7 项研究(n=2896),分析了卡利拉嗪对阳性和阴性症状量表(PANSS)评估的精神病症状的影响。
我们发现卡利拉嗪在急性精神病方面明显优于安慰剂(Hedges'g=0.40;95%置信区间 0.32-0.49),与主要精神诊断无关,并且在精神分裂症(Hedges'g=0.39;95%置信区间 0.29-0.50)和双相情感障碍患者(Hedges'g=0.43;95%置信区间 0.27-0.58)中也优于安慰剂。
我们提出,卡利拉嗪在治疗精神病时可能有用,而无需在治疗开始时进行分类学区分。关键点:抗精神病药物早期治疗精神病可改善预后并降低复发率。卡利拉嗪在急性精神病方面明显优于安慰剂,与主要精神诊断无关。卡利拉嗪在治疗开始时可能对精神分裂症和双相情感障碍之间的分类学区分无关,可用于治疗精神病。