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Current Neuropharmacology

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ISSN (Print): 1570-159X
ISSN (Online): 1875-6190

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Research Article

Therapeutic Appropriateness of Cariprazine in the Management of Schizophrenia: Experts’ Opinion using a Delphi Approach

Author(s): Bernardo Dell’Osso, Antonello Bellomo, Andreas Pietro Maria Conca, Virginio Salvi, Alberto Siracusano, Carmelo Zaffora, Domenico De Berardis* and Massimo Di Giannantonio

Volume 21, Issue 11, 2023

Published on: 20 July, 2023

Page: [2206 - 2216] Pages: 11

DOI: 10.2174/1570159X21666230719162023

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Abstract

Background: Schizophrenia is a psychiatric disorder whose therapeutic objectives are aimed at reducing symptoms and improving patient’s quality of life. First- and second-generation antipsychotics present numerous side effects. Recently introduced in the treatment of schizophrenia, cariprazine has shown to improve positive and negative symptoms as well as cognitive impairment, with good tolerability.

Objective: To assess the level of consensus among Italian psychiatrists in relation to the use of cariprazine in the treatment of schizophrenia by using the Delphi technique.

Method: A Delphi study was undertaken between January and July 2022. Two questionnaires were consecutively sent to a panel of 97 psychiatrists from all over Italy, of which 81 actively participated, anonymously, in at least one of the two consultations with a sufficiently high response rate (83%).

Results: Broad consensus in terms of the efficacy and safety of cariprazine in the treatment of schizophrenia during all phases of the disorder. The young first-episode schizophrenia patient with or without substance abuse seems to be an excellent candidate for cariprazine therapy. In addition, the lack of side effects makes cariprazine a suitable drug for adult and elderly patients with schizophrenia. However, there is still limited experience with the use of cariprazine, along with little knowledge of the most recent real-life data.

Conclusion: These results could encourage wider dissemination of evidence-based practices with the final aim of optimizing the clinical use of cariprazine in patients with schizophrenia.

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[1]
Amore, M.; Aguglia, A. Esperienze di switch a cariprazina in pazienti schizofrenici con comparsa di effetti collaterali/comorbilità mediche. Riv. Psichiatr., 2019, 54(6), 7-10.
[PMID: 32310933]
[2]
Riva, MA; Albert, U; de Filippis, S; Vita, A; De Berardis, D Identification of clinical phenotypes in schizophrenia: the role of lurasidone. Ther Adv Psychopharmacol., 2021, 10(11), 20451253211012250.
[http://dx.doi.org/10.1177/20451253211012250]
[3]
Cerveri, G.; Gesi, C.; Mencacci, C. Pharmacological treatment of negative symptoms in schizophrenia: Update and proposal of a clinical algorithm. Neuropsychiatr. Dis. Treat., 2019, 15(15), 1525-1535.
[http://dx.doi.org/10.2147/NDT.S201726] [PMID: 31239687]
[4]
Rocca, P.; Brasso, C.; Montemagni, C.; Bellino, S.; Rossi, A.; Bertolino, A.; Gibertoni, D.; Aguglia, E.; Amore, M.; Andriola, I.; Bellomo, A.; Bucci, P.; Buzzanca, A.; Carpiniello, B.; Cuomo, A.; Dell’Osso, L.; Favaro, A.; Giordano, G.M.; Marchesi, C.; Monteleone, P.; Oldani, L.; Pompili, M.; Roncone, R.; Rossi, R.; Siracusano, A.; Vita, A.; Zeppegno, P.; Galderisi, S.; Maj, M.; Bozzatello, P.; Badino, C.; Giordano, B.; Di Palo, P.; Calia, V.; Papalino, M.; Barlati, S.; Deste, G.; Ceraso, A.; Pinna, F.; Olivieri, B.; Manca, D.; Piegari, G.; Brando, F.; Giuliani, L.; Aiello, C.; Poli, L.F.; Concerto, C.; Surace, T.; Altamura, M.; Malerba, S.; Padalino, F.; Calcagno, P.; Murri, M.B.; Amerio, A.; Pacitti, F.; Socci, V.; Lucaselli, A.; Giusti, L.; Salza, A.; Ussorio, D.; Iasevoli, F.; Gramaglia, C.; Gambaro, E.; Gattoni, E.; Tenconi, E.; Collantoni, E.; Meneguzzo, P.; Ossola, P.; Tonna, M.; Gerra, M.L.; Carmassi, C.; Carpita, B.; Cremone, I.M.; Corrivetti, G.; Cascino, G.; Marciello, F.; Brugnoli, R.; Comparelli, A.; Corigliano, V.; Girardi, N.; Accinni, T.; Carlone, L.; Fagiolini, A.; Goracci, A.; Bolognesi, S.; Di Lorenzo, G.; Niolu, C.; Ribolsi, M. Italian Network for Research on Psychoses. Accuracy of self-assessment of real-life functioning in schizophrenia. NPJ Schizophr., 2021, 7(1), 11.
[http://dx.doi.org/10.1038/s41537-021-00140-9] [PMID: 33589645]
[5]
Barnes, T.R.E.; Drake, R.; Paton, C.; Cooper, S.J.; Deakin, B.; Ferrier, I.N.; Gregory, C.J.; Haddad, P.M.; Howes, O.D.; Jones, I.; Joyce, E.M.; Lewis, S.; Lingford-Hughes, A.; MacCabe, J.H.; Owens, D.C.; Patel, M.X.; Sinclair, J.M.A.; Stone, J.M.; Talbot, P.S.; Upthegrove, R.; Wieck, A.; Yung, A.R. Evidence-based guidelines for the pharmacological treatment of schizophrenia: Updated recommendations from the British Association for Psychopharmacology. J. Psychopharmacol., 2020, 34(1), 3-78.
[http://dx.doi.org/10.1177/0269881119889296] [PMID: 31829775]
[6]
Keepers, G.A.; Fochtmann, L.J.; Anzia, J.M.; Benjamin, S.; Lyness, J.M.; Mojtabai, R.; Servis, M.; Walaszek, A.; Buckley, P.; Lenzenweger, M.F.; Young, A.S.; Degenhardt, A.; Hong, S.H. The American Psychiatric association practice guideline for the treatment of patients with schizophrenia. Am. J. Psychiatry, 2020, 177(9), 868-872.
[http://dx.doi.org/10.1176/appi.ajp.2020.177901] [PMID: 32867516]
[7]
Hasan, A.; Falkai, P.; Wobrock, T.; Lieberman, J.; Glenthøj, B.; Gattaz, W.F.; Thibaut, F.; Möller, H.J. WFSBP Task Force on Treatment Guidelines for Schizophrenia. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia – a short version for primary care. Int. J. Psychiatry Clin. Pract., 2017, 21(2), 82-90.
[http://dx.doi.org/10.1080/13651501.2017.1291839] [PMID: 28498090]
[8]
Ventriglio, A.; Bellomo, A.; Ricci, F.; Magnifico, G.; Rinaldi, A.; Borraccino, L.; Piccininni, C.; Cuoco, F.; Gianfelice, G.; Fornaro, M.; Delle Monache, S.; De Berardis, D. New pharmacological targets for the treatment of schizophrenia: A literature review. Curr. Top. Med. Chem., 2021, 21(16), 1500-1516.
[http://dx.doi.org/10.2174/1568026621666210701103147] [PMID: 34218785]
[9]
Edinoff, A.; Ruoff, M.T.; Ghaffar, Y.T.; Rezayev, A.; Jani, D.; Kaye, A.M.; Cornett, E.M.; Kaye, A.D.; Viswanath, O.; Urits, I. Cariprazine to treat schizophrenia and bipolar disorder in adults. Psychopharmacol. Bull., 2020, 50(4), 83-117.
[PMID: 33012874]
[10]
Keks, N.; Hope, J.; Schwartz, D.; McLennan, H.; Copolov, D.; Meadows, G. Comparative tolerability of dopamine D2/3 receptor partial agonists for schizophrenia. CNS Drugs, 2020, 34(5), 473-507.
[http://dx.doi.org/10.1007/s40263-020-00718-4] [PMID: 32246399]
[11]
Correll, C.U.; Demyttenaere, K.; Fagiolini, A.; Hajak, G.; Pallanti, S.; Racagni, G.; Singh, S. Cariprazine in the management of negative symptoms of schizophrenia: state of the art and future perspectives. Future Neurol., 2020, 15(4), FNL52.
[http://dx.doi.org/10.2217/fnl-2020-0012]
[12]
Barabássy, Á.; Sebe, B.; Acsai, K.; Laszlovszky, I.; Szatmári, B.; Earley, W.R.; Németh, G. Safety and tolerability of cariprazine in patients with schizophrenia: A pooled analysis of eight phase II/III studies. Neuropsychiatr. Dis. Treat., 2021, 17, 957-970.
[http://dx.doi.org/10.2147/NDT.S301225] [PMID: 33854317]
[13]
Berardis, D.D.; Rapini, G.; Olivieri, L.; Giardini, A.; Lauretis, I.D.; Serroni, N.; Orsolini, L.; Fornaro, M.; Iasevoli, F.; Trotta, S.; Cottura, P.; Vellante, F.; Alessandrini, M.; Giannantonio, M.D. Cariprazine add-on in inadequate clozapine response: A report on two cases. Clin. Psychopharmacol. Neurosci., 2021, 19(1), 174-178.
[http://dx.doi.org/10.9758/cpn.2021.19.1.174] [PMID: 33508803]
[14]
Awad, G. Book Review: Stahl’s essential psychopharmacology, Prescriber’s guide, antipsychotics. Can. J. Psychiatry, 2019, 64(8)
[http://dx.doi.org/10.1177/0706743719856846]
[15]
Gesi, C.; Paletta, S.; Palazzo, M.C.; Dell’Osso, B.; Mencacci, C.; Cerveri, G. Cariprazine in three special different areas: A real-world experience. Neuropsychiatr. Dis. Treat., 2021, 17, 3581-3588.
[http://dx.doi.org/10.2147/NDT.S335332] [PMID: 34908838]
[16]
Fagiolini, A.; Alcalá, J.Á.; Aubel, T.; Bienkiewicz, W.; Bogren, M.M.K.; Gago, J.; Cerveri, G.; Colla, M.; Sanchez, F.C.; Cuomo, A.; Helge, F.; Iacoponi, E.; Karlsson, P.A.; Peddu, P.; Pettorruso, M.; Pereira, H.J.R.; Schölin, J.S.; Vernaleken, I.B. Treating schizophrenia with cariprazine: From clinical research to clinical practice. Real world experiences and recommendations from an International Panel. Ann. Gen. Psychiatry, 2020, 19(1), 55.
[http://dx.doi.org/10.1186/s12991-020-00305-3] [PMID: 32999683]
[17]
Leucht, S.; Crippa, A.; Siafis, S.; Patel, M.X.; Orsini, N.; Davis, J.M. Dose-response meta-analysis of antipsychotic drugs for acute schizophrenia. Am. J. Psychiatry, 2020, 177(4), 342-353.
[http://dx.doi.org/10.1176/appi.ajp.2019.19010034] [PMID: 31838873]
[18]
Rancans, E.; Dombi, Z.B.; Barabássy, Á. Dosing cariprazine within and beyond clinical trials: Recommendations for the treatment of schizophrenia. Front. Psychiatry, 2022, 12, 770234.
[http://dx.doi.org/10.3389/fpsyt.2021.770234] [PMID: 35069278]
[19]
Earley, W.; Durgam, S.; Lu, K.; Laszlovszky, I.; Debelle, M.; Kane, J.M. Safety and tolerability of cariprazine in patients with acute exacerbation of schizophrenia. Int. Clin. Psychopharmacol., 2017, 32(6), 319-328.
[http://dx.doi.org/10.1097/YIC.0000000000000187] [PMID: 28692485]
[20]
Nasa, P.; Jain, R.; Juneja, D. Delphi methodology in healthcare research: How to decide its appropriateness. World J. Methodol., 2021, 11(4), 116-129.
[http://dx.doi.org/10.5662/wjm.v11.i4.116] [PMID: 34322364]
[21]
Cascella, M.; Miceli, L.; Cutugno, F.; Di Lorenzo, G.; Morabito, A.; Oriente, A.; Massazza, G.; Magni, A.; Marinangeli, F.; Cuomo, A. On Behalf Of The Delphi Panel. A delphi consensus approach for the management of chronic pain during and after the COVID-19 Era. Int. J. Environ. Res. Public Health, 2021, 18(24), 13372.
[http://dx.doi.org/10.3390/ijerph182413372] [PMID: 34948983]
[22]
Correll, CU; Potkin, SG; Zhong, Y; Harsányi, J; Szatmári, B; Earley, W Long-term remission with cariprazine treatment in patients with schizophrenia: A post hoc analysis of a randomized, doubleblind, placebo-controlled, relapse prevention trial. J. Clin. Psychiatry., 2019, 80(2), 18m12495.
[23]
Mohr, P.; Masopust, J.; Kopeček, M. Dopamine receptor partial agonists: Do They differ in their clinical efficacy? Front. Psychiatry, 2022, 12, 781946.
[http://dx.doi.org/10.3389/fpsyt.2021.781946] [PMID: 35145438]
[24]
Vita, A.; Ceraso, A.; Valsecchi, P. Esperienze di switch a cariprazina in pazienti affetti da schizofrenia con ricorrenze. Riv. Psichiatr., 2019, 54(6), 16-19.
[PMID: 32310935]
[25]
Mencacci, C.; Cerveri, G.; Palazzo, C.; Gesi, C.; Salvi, V. Esperienze di switch a cariprazina in pazienti affetti da schizofrenia con risposta parziale. Riv. Psichiatr., 2019, 54(6), 11-15.
[PMID: 32310934]
[26]
Cernea, S.; Dima, L.; Correll, C.U.; Manu, P. Pharmacological management of glucose dysregulation in patients treated with second-generation antipsychotics. Drugs, 2020, 80(17), 1763-1781.
[http://dx.doi.org/10.1007/s40265-020-01393-x] [PMID: 32930957]
[27]
Szatmári, B.; Barabássy, Á.; Harsányi, J.; Laszlovszky, I.; Sebe, B.; Gál, M.; Shiragami, K.; Németh, G. Cariprazine safety in adolescents and the elderly: Analyses of clinical study data. Front. Psychiatry, 2020, 11, 61.
[http://dx.doi.org/10.3389/fpsyt.2020.00061] [PMID: 32194443]
[28]
Citrome, L. Cariprazine for acute and maintenance treatment of adults with schizophrenia: an evidence-based review and place in therapy. Neuropsychiatr. Dis. Treat., 2018, 14, 2563-2577.
[http://dx.doi.org/10.2147/NDT.S159704] [PMID: 30323605]
[29]
Fagiolini, A.; Bolognesi, S.; Goracci, A.; Beccarini Crescenzi, B.; Cuomo, A. Principi di farmacodinamica e farmacocinetica nello switch tra antipsicotici: focus su cariprazina. Riv. Psichiatr., 2019, 54(6), 1-6.
[PMID: 32310932]
[30]
Cutler, A.J.; Durgam, S.; Wang, Y.; Migliore, R.; Lu, K.; Laszlovszky, I.; Németh, G. Evaluation of the long-term safety and tolerability of cariprazine in patients with schizophrenia: results from a 1-year open-label study. CNS Spectr., 2018, 23(1), 39-50.
[http://dx.doi.org/10.1017/S1092852917000220] [PMID: 28478771]

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