Barabassy Agota, Csehi Réka, Dombi Zsófia Borbála, Szatmári Balázs, Brevig Thomas, Németh György
Global Medical Division, Gedeon Richter Plc, 1103 Budapest, Hungary.
Pharmaceuticals (Basel). 2025 Jul 2;18(7):995. doi: 10.3390/ph18070995.
: The introduction of the transdiagnostic approach in psychiatry shifts the focus from discrete diagnoses to shared symptoms across various disorders. The Transdiagnostic Global Impression-Psychopathology (TGI-P) scale is a newly developed tool designed to assess psychiatric symptoms across diagnostic boundaries. It evaluates ten core symptom domains-positive, negative, cognitive, manic, depressive, addiction, anxiety, sleep, hostility, and self-harm-regardless of specific diagnoses. Objective: This study aims to evaluate the efficacy of cariprazine across these ten transdiagnostic symptom domains. : A systematic literature review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were performed on EMBASE and clinicaltrials.gov. Efficacy measures such as the Positive and Negative Syndrome Scale (PANSS), Montgomery-Åsberg Depression Rating Scale (MADRS), Young Mania Rating Scale (YMRS), Hamilton Anxiety Rating Scale (HAM-A), and Columbia-Suicide Severity Rating Scale (C-SSRS) were used to assess cariprazine's effect on the ten transdiagnostic symptoms. Multilevel random-effects meta-analyses were conducted to evaluate the efficacy of cariprazine versus placebo in alleviating depressive and anxiety symptoms across clinical trials. : A total of 30 studies were included in the review. Cariprazine showed therapeutic benefits on positive, negative, manic, and depressive symptoms in specifically designed trials. Preliminary positive effects were seen on anxiety, hostility, and cognitive symptoms across disorders. However, specific trials have not been conducted for anxiety disorders or cognitive impairment. Meta-analyses demonstrated that cariprazine significantly reduces both depressive and anxiety symptoms compared to placebo. Cariprazine significantly improved sleep-related symptoms in both mania and depression trials. Suicidality was evaluated in non-suicidal populations, and no increase was observed. Addiction symptoms were part of the exclusion criteria in the RCTs, so they could not be assessed. Previous reports of cariprazine's anti-craving and anti-abuse effects come from real-world evidence rather than RCT data. : Cariprazine appears to be promising in addressing a broad range of symptom domains across psychiatric conditions.
精神病学中跨诊断方法的引入将焦点从离散诊断转向各种障碍中的共同症状。跨诊断总体印象-精神病理学（TGI-P）量表是一种新开发的工具，旨在评估跨越诊断界限的精神症状。它评估十个核心症状领域——阳性、阴性、认知、躁狂、抑郁、成瘾、焦虑、睡眠、敌意和自我伤害——而不考虑具体诊断。目的：本研究旨在评估卡立普唑在这十个跨诊断症状领域的疗效。：按照系统评价和Meta分析的首选报告项目（PRISMA）指南进行了系统的文献综述和Meta分析。在EMBASE和clinicaltrials.gov上进行了检索。使用阳性和阴性症状量表（PANSS）、蒙哥马利-阿斯伯格抑郁评定量表（MADRS）、杨氏躁狂评定量表（YMRS）、汉密尔顿焦虑评定量表（HAM-A）和哥伦比亚自杀严重程度评定量表（C-SSRS）等疗效指标来评估卡立普唑对这十个跨诊断症状的影响。进行了多层次随机效应Meta分析，以评估卡立普唑与安慰剂在减轻临床试验中抑郁和焦虑症状方面的疗效。：该综述共纳入30项研究。在专门设计的试验中，卡立普唑对阳性、阴性、躁狂和抑郁症状显示出治疗益处。在各种障碍中，对焦虑、敌意和认知症状初步显示出积极效果。然而，尚未针对焦虑症或认知障碍进行具体试验。Meta分析表明，与安慰剂相比，卡立普唑显著减轻抑郁和焦虑症状。在躁狂和抑郁试验中，卡立普唑均显著改善了与睡眠相关的症状。在非自杀人群中评估了自杀倾向，未观察到增加。成瘾症状是随机对照试验中的排除标准之一，因此无法进行评估。之前关于卡立普唑抗渴望和抗滥用作用的报告来自真实世界证据而非随机对照试验数据。：卡立普唑在解决广泛的精神疾病症状领域方面似乎很有前景。
