Vraylar (Cariprazine) May Benefit Negative Symptoms of Schizophrenia
Vraylar (Cariprazine) May Benefit Negative Symptoms of Schizophrenia
Dr. Danish and his team recognize the challenge of treating the negative symptoms of schizophrenia, commonly known as the 4A's: affective flattening, alogia, anhedonia, and avolition. Historically, only a few treatments have shown limited success in addressing these symptoms. Cariprazine (Vraylar), an FDA-approved medication for schizophrenia, operates as a partial agonist at dopamine D2/D3 and serotonin 5-HT1A receptors. By stabilizing these neurotransmitters, cariprazine not only mitigates positive symptoms but also alleviates negative symptoms such as blunted affect, alogia, and anhedonia. The effectiveness of cariprazine in treating negative symptoms has been validated through various studies. This blog explores a recent comprehensive review of numerous articles on cariprazine.
Pharmacological Profile of Cariprazine
Cariprazine is a third-generation antipsychotic approved by the US FDA in 2015 for the treatment of schizophrenia, bipolar I disorder, and as an adjunctive therapy for major depressive disorder. It is distinct from other antipsychotics due to its high affinity for dopamine D3 receptors, partial agonism at D2/D3 receptors, and partial agonism at serotonin receptors, all of which contribute to its efficacy in treating negative symptoms with fewer metabolic and hormonal side effects.
Cariprazine's longer half-life contributes to its sustained therapeutic effects even with occasional missed doses, reducing the risk of relapse and discontinuation syndrome.
Clinical Efficacy
Improvement in Negative Symptoms
Cariprazine has shown significant efficacy in improving negative symptoms of schizophrenia. In a phase III randomized trial, cariprazine demonstrated greater improvement in predominant negative symptoms compared to risperidone, starting from approximately three months of treatment. This improvement was independent of positive and depressive symptoms, highlighting cariprazine's specific benefit for negative symptoms.
Treatment Adherence
Patients treated with cariprazine have shown better adherence to treatment regimens compared to those on other antipsychotics. This is attributed to its favorable side effect profile and the reduction in negative symptoms, which can enhance overall quality of life and social functioning.
Safety and Tolerability
Common Adverse Effects
For a comprehensive list of potential side effects, visit drugs.com.
The most common adverse effects associated with cariprazine include extrapyramidal symptoms (EPS) and akathisia. Nausea and lethargy also can occur. A growing list of medium-term studies have demonstrated that cariprazine is generally well-tolerated, with consistent safety profiles over extended treatment periods for most patients.
Long-Term Safety
We are optimistic that cariprazine may be linked to a lower risk of metabolic syndrome and a significantly reduced risk of tardive dyskinesia. However, as a newer medication, these potential benefits still need to be fully clarified through further research.
Getting in Touch with Dr. Danish and His Team
At Philadelphia Integrative Psychiatry, we take pride in our ability to practice the most subtle nuances of psychiatry, which is an inherently subjective field full of misdiagnoses and lazy and inaccurate assessment techniques. We want to provide the level of care we would want for our own family members. Our holistic and integrative approach ensures that we consider all aspects of our patients' well-being in developing personalized treatment plans. If you or a loved one are seeking support for schizophrenia or similar conditions, please text or call 610-999-6414 to learn how we can help.
For more on this topic and related subjects, check out these blogs:
Read Dr. Danish’s blog on the many subtypes of bipolar disorder.
Here is a blog that addresses some of the differences between true bipolar disorder and mood swings from other causes.
Please read this important blog on the risk for a movement disorder called tardive dyskinesia (TD), that can be caused by various medications, including antipsychotics.
Here is a breakdown of a commonly prescribed mood stabilizer and antipsychotic, Abilify (aripiprazole), which is used on- and off-label to treat a variety of disorders.
Sources:
