Cariprazine: uses and side effects of this psychoactive drug

Psychotic disorders, with schizophrenia as the main and most recognized representative, are one of the types of mental disorder that generates the greatest amount of suffering and functional alteration in the lives of the people who suffer from it suffer.

Finding a treatment that alleviates the symptoms and maintains stability in these subjects has been the objective of a large amount of research from different disciplines. Pharmacology is one of them, having synthesized different substances that temporarily reduce or eliminate psychotic symptoms. We are talking about antipsychotics. One of them, approved in 2015, is cariprazine.

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Cariprazine as an antipsychotic

Cariprazine is a substance developed and approved by the FDA in 2015, classified as an atypical antipsychotic. It is a substance with great effectiveness and elaborated with the purpose of suppressing or reducing psychotic symptoms, both at the level of symptoms that increase the activity or add elements to the normal functionality of the patient (called positive symptoms), such as hallucinations, delusions, restlessness or disorganization of the thought.

However, this drug seems to be more effective than other drugs such as risperidone in the treatment of negative symptoms. So, has a greater effect on those symptoms that reduce the level of activation of the patientsuch as alogia or poverty of thought or abulia and anhedonia or inability to be motivated or feel pleasure.

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Mechanism of action

Cariprazine is considered an atypical or second-generation antipsychotic. As such, it affects brain neurochemistry by altering the dopaminergic and serotonergic systems. Unlike most antipsychotics, which block the dopamine brain, cariprazine is considered a partial agonist of said neurotransmitter (that is, they generate an effect similar to that of endogenous dopamine), something that has been seen associated with the improvement in the negative symptoms generated by the deficit of this hormone at the mesocortical.

Likewise, at the level of serotonin we find that it plays different roles depending on the receptor in question. It acts as a partial agonist of the 5-HT1a receptor, which influences the reduction of dopamine synthesis in some brain areas, while which acts as an antagonist of the 5-HT2a and 5-HT2b receptors (which on the other hand generates an increase in dopamine levels in the pathway mesocortical). likewise also affects, although to a much lesser extent, the noradrenergic and histaminergic systems, something that can influence when it comes to generating side effects.

Main uses

The main indication for cariprazine is schizophrenia., in which it seems to have a high level of effectiveness in the treatment of both positive and negative symptoms. Its use is also common in other psychotic disorders, especially those that present with delusions, agitation and hallucinations.

It has also been indicated for some cases of Bipolar disorder. Specifically, its use has been approved in the presence of acute manic or mixed episodes, helping to reduce the current level of hyperarousal and excessively expansive mood.

Although it does not yet have such action, The possible application of this drug in cases of depression is yet to be investigated. (both unipolar and in depressive episodes of bipolar disorder) or even in autism, similar to what occurs with aripiprazole and risperidone.

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Side effects and contraindications

Although highly effective in the treatment of different conditions and mental disorders, cariprazine is a substance that can also generate different side effects and even be completely contraindicated (or require extreme regulation) for some specific types of population.

As far as side effects are concerned, it is common to cause drowsiness and weight gain, being the most frequent and well-known symptoms. However, in addition to this, it can cause agitation, dizziness, problems urinating or defecating, stomach problems such as indigestion, hypersalivation or blurred vision. In addition to this, other more serious problems that may require medical attention are the possible experimentation of seizures, muscle weakness, dark coloration of urine (due to urination problems), loss of facial expression, falls, hyperthermia or alterations of consciousness, tachycardia, hyperglycemia and hypotension.

Some motor symptoms such as tremors and involuntary movements (like those of dyskinesia) are also possible. As with the rest of antipsychotics or neuroleptics also care must be taken with the possible appearance of neuroleptic malignant syndrome, potentially deadly.

Regarding contraindications, as with many other antipsychotics, special caution should be taken with this medication by people receiving other pharmacological treatments, especially in the case of antidepressants, since there are a large number of drug substances that can interact with the cariprazine. Diabetics should be especially careful, since it is common for this drug to generate elevations in blood sugar that leads to hyperglycemia.

In addition should be avoided by patients with cardiovascular disorders, who have suffered some type of stroke or who present dementia (multiplying in this case the risk of mortality). Its consumption should also be avoided during pregnancy, requiring a consultation with the doctor to evaluate alternatives, since it can be a risk for the appearance of malformations or alterations in the fetus.