Efficacy and safety of cariprazine augmentation in patients treated with clozapine: a pilot study
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Author(s)
Type
Journal Article
Abstract
Background: Cariprazine, a novel antipsychotic drug is a partial agonist of dopamine D2/D3 receptors with preferential binding to the D3 receptor. There has been an increasing interest in cariprazine augmentation to clozapine, however the evidence thus far has been only limited to case reports and case series.
Aim: To evaluate the efficacy and safety of the augmentation of clozapine with cariprazine in patients with sub-optimal treatment response.
Methods: Demographic and clinical information of the study population were collected from the electronic records and PANSS scale administered at baseline and three months. Tolerability and discontinuation reasons where applicable were also recorded.
Results: Ten patients (4 men and 6 women) with a mean age of 36.5 years (range 26-45) were included. Reasons for cariprazine initiation included inadequate treatment response, persistent negative symptoms and/or tolerability issues with clozapine or previous augmentation options. Two patients discontinued cariprazine within the first 6 weeks due to restlessness and poor response, respectively. There was a significant reduction in the median total PANSS score from baseline to 3 months (from 59 to 22.5, p<0.05), median positive PANSS score (11.5 to 5.5, p<0.05) and in the median negative PANSS score (from 15.5 to 3, p<0.05) which correspond to a 48%, 33.8% and 65.8% mean score reduction respectively.
Conclusion: This is the first pilot study evaluating the effectiveness of clozapine augmentation. The preliminary evidence suggests that this may be a safe and effective practice in patients failing to adequately respond to or tolerate clozapine and/or previous augmentation strategies.
Aim: To evaluate the efficacy and safety of the augmentation of clozapine with cariprazine in patients with sub-optimal treatment response.
Methods: Demographic and clinical information of the study population were collected from the electronic records and PANSS scale administered at baseline and three months. Tolerability and discontinuation reasons where applicable were also recorded.
Results: Ten patients (4 men and 6 women) with a mean age of 36.5 years (range 26-45) were included. Reasons for cariprazine initiation included inadequate treatment response, persistent negative symptoms and/or tolerability issues with clozapine or previous augmentation options. Two patients discontinued cariprazine within the first 6 weeks due to restlessness and poor response, respectively. There was a significant reduction in the median total PANSS score from baseline to 3 months (from 59 to 22.5, p<0.05), median positive PANSS score (11.5 to 5.5, p<0.05) and in the median negative PANSS score (from 15.5 to 3, p<0.05) which correspond to a 48%, 33.8% and 65.8% mean score reduction respectively.
Conclusion: This is the first pilot study evaluating the effectiveness of clozapine augmentation. The preliminary evidence suggests that this may be a safe and effective practice in patients failing to adequately respond to or tolerate clozapine and/or previous augmentation strategies.
Date Issued
2022-11-21
Date Acceptance
2022-09-23
Citation
Therapeutic Advances in Psychopharmacology, 2022, 12, pp.1-7
ISSN
2045-1253
Publisher
SAGE Publications
Start Page
1
End Page
7
Journal / Book Title
Therapeutic Advances in Psychopharmacology
Volume
12
Copyright Statement
© The Author(s), 2022, Article Reuse Guidelines. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(https://us.sagepub.com/en-us/nam/open-access-at-sage).
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Identifier
https://journals.sagepub.com/doi/10.1177/20451253221132087
Publication Status
Published
Date Publish Online
2022-11-21