Stanislav V IvanovSechenov First Moscow State Medical University, Russian Federation
Title: Cariprazine in schizophrenia with predominantly negative symptoms: Early effects at the first stage of therapy (observational study)
Background: Limited efficacy of antipsychotics against negative symptoms in schizophrenia and new drugs with wider spectrums of clinical efficacy are very desirable. The newer 3rd generation antipsychotic Cariprazine with unique mode of action – partial agonist predominantly for dopamine D3- and in lesser extent D2-receptors found to be effective in the treatment of negative symptoms in schizophrenia comparing to second generation antipsychotic risperidone.
Objectives: To evaluate initial effects of Cariprazine in schizophrenia patients with predominantly negative symptoms.
Design and patients: Open-lable observational study included 60 adult schizophrenia patients (F20 on ICD-10, 49% males) with predominantly negative symptoms (PANSS-FSNS ? 15, PANSS-FSPS < 19) treated with Cariprazine (starting daily dose 1,5 mg followed by upward titration by 1,5 mg weekly up to 6 mg if needed) were assessed with PANSS, CAINS, CDSS and SAS scales at baseline and on week 1, 2, and 4.
Results: Most patients (75%) improved during 28 days of cariprazine treatment. At the end of assessment (day 28) mean starting total scores for negative symptoms on PANSS-NS and CAINS scales significantly (p<0.05) reduced by 4,3 and 4,9 respectively with no significant changes in depression symptoms (CDSS). Cariprazine tolerability was very good, only 4 patients discontinued because of TEAEs (akathisia, insomnia).
Conclusions: The results of this observational study suggest early effect of Cariprazine on negative symptoms at least in some schizophrenia patients with predominantly negative symptoms starting from 1-2 weeks of treatment and could be useful for determination of early clinical predictors for efficacy. Considering limitations of observational open-lable design with no control groups these data need to be confirmed.
After graduating from the institute, from 1987 to 1988, he completed an internship in the specialty "Psychiatry" at the Psychiatric Clinical Hospital No. 1 (now the Psychiatric Clinical Hospital No. 1 named after N.A. Alekseev). In 1994, he was awarded the degree of candidate of medical sciences, in 2002, the degree of doctor of medical sciences. In May 2011 he was awarded the academic title of professor in the specialty "Psychiatry". 1 doctoral and 7 master's theses were defended under supervision. He is the author of more than 130 scientific papers, including 4 monographs, sections in 7 domestic, including national, manuals on psychiatry and psychosomatics.