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Treating schizophrenia with cariprazine

2020-09-26Recensão Acesso aberto
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dc.contributor.authorFagiolini, Andrea
dc.contributor.authorAlcalá, José Ángel
dc.contributor.authorAubel, Thomas
dc.contributor.authorBienkiewicz, Wojciech
dc.contributor.authorBogren, Mats Magnus Knut
dc.contributor.authorGago, Joaquim
dc.contributor.authorCerveri, Giancarlo
dc.contributor.authorColla, Michael
dc.contributor.authorSanchez, Francisco Collazos
dc.contributor.authorCuomo, Alessandro
dc.contributor.authorHelge, Frieling
dc.contributor.authorIacoponi, Eduardo
dc.contributor.authorKarlsson, Per Axel
dc.contributor.authorPeddu, Pradeep
dc.contributor.authorPettorruso, Mauro
dc.contributor.authorPereira, Henrique Jorge Ramos
dc.contributor.authorSchölin, Johan Sahlsten
dc.contributor.authorVernaleken, Ingo Bernd
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblBioMed Central (BMC)
dc.date.accessioned2020-10-19T23:26:25Z
dc.date.available2020-10-19T23:26:25Z
dc.date.issued2020-09-26
dc.description.abstractBackground: Management of schizophrenia is sub-optimal in many patients. Targeting negative symptoms, among the most debilitating aspects of schizophrenia, together with positive symptoms, can result in significant functional benefits and dramatically improve quality of life for patients and their carers. Cariprazine, a partial agonist of the dopamine receptors D2/D3 has demonstrated effectiveness across symptom domains in clinical trials, particularly on negative symptoms. Objective: To obtain a broader insight from clinicians with specific experience with cariprazine, on how it affects patient populations outside the clinical trial setting. Methods: The panel addressed a series of psychopharmacologic topics not comprehensively addressed by the evidence-based literature, including characteristics of patients treated, dosing and switching strategies, duration of therapy, role of concomitant medications and tolerability as well as recommendations on how to individualize cariprazine treatment for patients with schizophrenia. Results: Patients recommended for cariprazine treatment are those with first episodes of psychosis, predominant negative symptoms (maintenance/acute phase) and significant side effects (metabolic side effects, hyperprolactinemia, sedation) with other antipsychotics. When the long-term treatment of a lifetime illness is adequately weighted, cariprazine becomes one of the first-line medications, not only for patients with predominant negative symptoms but also for those with relatively severe positive symptoms, especially if they are at the first episodes and if a specific medication is added for symptoms such as agitation or insomnia. For instance, patients with agitation may also benefit from the combination of cariprazine and a benzodiazepine or another sedating agent. Cariprazine may be prescribed as add-on to medications such as clozapine, when that medication alone is ineffective for negative symptoms, and sometimes the first may be discontinued or its dose lowered, after a period of stability, leaving the patient on a better tolerated antipsychotic regimen. Conclusions: Based on real-world clinical experience, the panel considered that cariprazine, with its distinct advantages including pharmacokinetics/pharmacodynamics, good efficacy and tolerability, represents a drug of choice in the long-term management of schizophrenia not only for patients with predominant negative symptoms but also for those with positive symptoms.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent1102622
dc.identifier.doi10.1186/s12991-020-00305-3
dc.identifier.otherPURE: 25991467
dc.identifier.otherPURE UUID: 653b5fd8-8036-40ea-9f15-1a18ca7e2476
dc.identifier.otherScopus: 85092268666
dc.identifier.otherPubMed: 32999683
dc.identifier.otherWOS: 000575639800001
dc.identifier.urihttp://hdl.handle.net/10362/105902
dc.identifier.urlhttps://www.scopus.com/pages/publications/85092268666
dc.language.isoeng
dc.peerreviewedyes
dc.subjectAntipsychotics
dc.subjectCariprazine
dc.subjectNegative symptoms
dc.subjectPatient subgroups
dc.subjectRecommendations
dc.subjectSchizophrenia
dc.subjectPsychiatry and Mental health
dc.subjectSDG 3 - Good Health and Well-being
dc.titleTreating schizophrenia with cariprazineen
dc.title.subtitleFrom clinical research to clinical practice. Real world experiences and recommendations from an International Panelen
dc.typereview
degois.publication.issue1
degois.publication.titleAnnals of General Psychiatry
degois.publication.volume19
dspace.entity.typePublication
rcaap.rightsopenAccess

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