Abstract
The gap between expectations and reality in treatment of schizophrenia can be termed "unmet needs". Examples of needs in pharmacotherapy are problematic adherence, side effects (tolerability), and poor efficacy of antipsychotics in specific symptom domains, especially negative, cognitive, and depressive symptoms.
If our ultimate goal in schizophrenia treatment is recovery, as indexed by social functioning, then insufficient improvement of negative symptoms represents a copybook example of unmet need. Efficacy of antipsychotics in negative symptoms is generally low; promising potential was demonstrated by cariprazine, a new partial agonist of D2/D3 receptors with preferential affinity to D3 receptors.
In Europe cariprazine has been registered for treatment of schizophrenia in adults. Cariprazine proved its efficacy in acute schizophrenia and in long-term therapy in relapse prevention.
Additionally, in a six-month study with predominant negative symptoms of schizophrenia, cariprazine was significantly more effective than risperidone in reduction of primary negative symptoms and also in improvement of psychosocial patient functioning. Short-and long-term tolerability of cariprazine was very good; most side effects were of mild or moderate severity.
The most frequent side effects reported were akathisia and EPS, however in most cases they did not lead to discontinuation of the treatment. Cariprazine has minimal effect on weight gain, is metabolicaly neutral, does not increase prolactin level and has no sedation effect.
It proved to be and effective and well-tolerated antipsychotic that can be used in treatment of predominant negative symptoms of schizophrenia. Moreover, given its receptor profile, it can be presumably utilized for other unmet needs in schizophrenia treatment, as well.