Reznik Aleksandr M, Arbuzov Aleksandr L, Murin Sergey P
Medical Institute of Continuing Education of «Moscow National University of Food Production».
Mental-health Clinic No. 1 named after N.A. Alexeev.
Consort Psychiatr. 2020 Dec 4;1(2):43-51. doi: 10.17650/2712-7672-2020-1-2-43-51.
Cariprazine is a new piperazine derivative atypical antipsychotic, like aripiprazole and brexpiprazole. It has been approved for treating schizophrenia in many countries and has recently been included on the List of Essential Medicines in Russia. Unlike most other atypical antipsychotics, it shows high occupancy of dopamine D2 and D3 receptors at clinically relevant doses. In animal models, cariprazine has demonstrated dopamine D3 receptor-dependent pro-cognitive and anti-anhedonic effects, suggesting its potential for treating negative symptoms. This review summarizes the efficacy of cariprazine in the treatment of negative symptoms of schizophrenia.
A literature search of databases covering international and Russian journals, for articles published between 1st January 2010 and 1st June 2020.
Cariprazine demonstrated at least comparable efficacy in the treatment of schizophrenia symptoms to active comparators including risperidone, olanzapine or aripiprazole. The drug has a good safety profile. It appeared to be associated with a lower risk of metabolic syndromes and most extrapyramidal symptoms. The positive effect of cariprazine on the negative symptoms of schizophrenia may be associated with the elimination of secondary negative symptoms. However, of all the atypical antipsychotics to date, only cariprazine has a convincingly, methodologically robust proven advantage over risperidone in eliminating the predominant negative symptoms of schizophrenia. Yet only four studies have investigated the effect of cariprazine on the negative symptoms of schizophrenia. There is a lack of research into its direct impact on emotional-volitional disorders, anhedonia, cognitive symptoms and personality changes. However, there is evidence to suggest cariprazine is effective in treatment-resistant cases, but this requires further confirmation.
Cariprazine is an effective and well-tolerated agent for the treatment of schizophrenia and may be effective in cases where other antipsychotics have failed. Cariprazine has been shown to have a positive effect on negative symptoms. Further studies are needed to collect more data on long-term treatment of schizophrenia and especially negative symptoms.
卡立哌嗪是一种新型哌嗪衍生物非典型抗精神病药物，与阿立哌唑和布雷斯哌唑类似。它已在许多国家获批用于治疗精神分裂症，最近还被列入俄罗斯基本药物清单。与大多数其他非典型抗精神病药物不同，在临床相关剂量下，它对多巴胺D2和D3受体具有高占有率。在动物模型中，卡立哌嗪已证明具有多巴胺D3受体依赖性的促认知和抗快感缺失作用，表明其具有治疗阴性症状的潜力。本综述总结了卡立哌嗪治疗精神分裂症阴性症状的疗效。
检索涵盖国际和俄罗斯期刊的数据库，查找2010年1月1日至2020年6月1日期间发表的文章。
卡立哌嗪在治疗精神分裂症症状方面至少与活性对照药物（包括利培酮、奥氮平或阿立哌唑）疗效相当。该药物具有良好的安全性。它似乎与代谢综合征和大多数锥体外系症状的风险较低有关。卡立哌嗪对精神分裂症阴性症状的积极作用可能与消除继发性阴性症状有关。然而，在迄今为止所有的非典型抗精神病药物中，只有卡立哌嗪在消除精神分裂症的主要阴性症状方面相对于利培酮具有令人信服的、方法学上可靠的已证实优势。然而，仅有四项研究调查了卡立哌嗪对精神分裂症阴性症状的影响。缺乏对其对情感意志障碍、快感缺失、认知症状和人格改变的直接影响的研究。然而，有证据表明卡立哌嗪在难治性病例中有效，但这需要进一步证实。
卡立哌嗪是一种有效且耐受性良好的治疗精神分裂症的药物，在其他抗精神病药物治疗失败的情况下可能有效。卡立哌嗪已被证明对阴性症状有积极作用。需要进一步研究以收集更多关于精神分裂症长期治疗尤其是阴性症状治疗的数据。
