Vraylar (cariprazine) / Tanabe Pharma, Recordati, Gedeon Richter, AbbVie, Hwanin Pharma - LARVOL DELTA

When Anatomy Overrides Algorithm: Refractory Constipation in an Adult With Cloacal Malformation (ACG 2026) - "Her medications included clomipramine and cariprazine, both associated with constipation. Sagittal MR defecography at rest (left panel) and during evacuation (right panel) demonstrating pelvic floor descent, small anterior rectocele, and small-to-moderate peritoneocele in the setting of postsurgical pelvic floor distortion from prior anorectal reconstruction. Rectal gel is visible within the reconstructed anorectal canal."

Clinical • Colorectal Cancer • Constipation • Gastroenterology • Gastrointestinal Disorder • Inflammatory Bowel Disease • Solid Tumor

Acute catatonia and psychosis in the context of seizure exacerbation in epilepsy: a case report. (PubMed, Front Psychiatry) - "We report a 44-year-old woman with a 27-year history of epilepsy, maintained on carbamazepine and topiramate, and a longstanding psychiatric history of major depressive disorder, obsessive-compulsive symptoms, and chronic nihilistic delusions and intermittent hallucinations documented at baseline. One week before admission, her antidepressant was switched from clomipramine to venlafaxine 150 mg/day...Management with escalating benzodiazepines and cautious antipsychotic uptitration (quetiapine XR, cariprazine) was associated with complete catatonic remission and psychotic symptom resolution over 29 days...Clinicians should resist anchoring on temporal associations between seizure activity and psychiatric symptoms. EEG findings must be interpreted in their pharmacological context; pharmacokinetic interactions should inform antipsychotic dose selection; and QTc prolongation warrants structured cardiac monitoring."

Journal • Anesthesia • CNS Disorders • Depression • Epilepsy • Major Depressive Disorder • Mental Retardation • Mood Disorders • Psychiatry • CYP3A4

A Summary for Non-Psychiatrists of the Australian and New Zealand Journal of Psychiatry Grading of Recommendations, Assessment, Development and Evaluations (GRADE) Guidelines for the Management of Schizophrenia. (PubMed, Med J Aust) - "A comprehensive yet tailored clinical assessment should be undertaken to identify treatable physical health comorbidities early, particularly for people with early psychosis. Pharmacotherapy should aim for the lowest effective dose with a tolerable and manageable adverse-effect profile (e.g., first-line pharmacotherapy with aripiprazole, brexpiprazole, cariprazine or lurasidone). Lifestyle interventions, particularly physical activity and multimodal lifestyle programmes, should be routinely offered to people with schizophrenia. Psychological and psychosocial interventions are essential components of care for people with schizophrenia, especially during the maintenance phase of illness. Clinicians should actively involve people with schizophrenia and their family, whānau and carers in shared decision-making. Comorbid psychiatric symptoms and conditions should be assessed and managed according to standard treatment approaches until more robust evidence base specific to..."

Journal • CNS Disorders • Psychiatry • Schizophrenia

Interim data from ENIGMA – TRS 1 study of evenamide as add on therapy to antipsychotic Standard of Care in patients with treatment resistant schizophrenia (TRS). Difficulties in performing TRS study with TRRIP criteria: the CRO experience (WFSBP 2026) - "One aspect of the ENIGMA – TRS 1 study assesses plasma concentrations of standard of care as selected antipsychotics: Aripiprazole, Brexpiprazole, Cariprazine, Clozapine, Lurasidone, Olanzapine, Paliperidone, Quetiapine, Risperidone and Ziprasidone for subjects treated with those antipsychotics with daily therapeutic doses meeting local product labels requirements and correlated those with minimal duration of 6 weeks treatment with any of those medications. As the study is performed in 20 countries worldwide major issues reside in getting approval by all regulatory approvals, languages use for the rating instruments as well as for the training of the raters. Based on hundreds of patients entering screening, a large proportion failed the screening phase because of lack of adequate concentration of the primary AP. Difficulties have been noticed in ensuring adequate documentation of previous AP failures."

Clinical • CNS Disorders • Psychiatry • Schizophrenia

The structure of the dopamine D3 receptor bound to cariprazine reveals principles for partial agonists with designed pharmacology. (PubMed, Sci Adv) - "Leveraging these principles, we designed and validated cariprazine derivatives with enhanced D3/D2 selectivity and partial agonist activity. Together, this work provides a structural and pharmacological blueprint for the rational design of D3R-targeting ligands with tailored efficacy and therapeutic profiles."

Journal • CNS Disorders

From Chromatographic Optimisation to Bioanalysis: HPLC System Comparison and HPLC-QTRAP-MS/MS Determination of Cariprazine and Lurasidone in Human Serum, Urine, and Saliva. (PubMed, Int J Mol Sci) - "The method was successfully applied for the determination of CAR and LUR in biological samples obtained from psychiatric patients. The findings suggest that saliva may be a non-invasive alternative for the quantification of free levels of investigated drugs, although further studies are required to clarify its relationship with plasma concentrations."

Clinical • Journal • CNS Disorders • Psychiatry • Schizophrenia

Cariprazine in First-Episode Psychosis with Comorbid Cannabis Use: A Case Series of Eight Patients from Two Greek Early Intervention Units. (PubMed, Brain Sci) - " These preliminary, hypothesis-generating observations suggest that cariprazine may warrant further study in FEP with comorbid cannabis use. The findings cannot be interpreted as evidence of efficacy given the small, uncontrolled, diagnostically heterogeneous sample."

Journal • CNS Disorders • Depression • Mood Disorders • Psychiatry

Clinical Utility of Cariprazine in the Management of Acute Schizophrenia: Current Evidence and Practical Recommendations. (PubMed, Actas Esp Psiquiatr) - "Cariprazine is a valuable tool for the stabilization and long-term functional recovery of patients in acute psychiatric units. The consensus provides a practical framework to optimize its clinical application based on high-quality evidence."

Journal • Review • CNS Disorders • Psychiatry • Schizophrenia

Cariprazine and Lithium Overdose: A Case Report. (PubMed, Cureus) - "A 24-year-old woman with a history of bipolar affective disorder and borderline personality disorder presented following an intentional overdose of approximately 60 mg of cariprazine and 3.75-5 g of lithium carbonate and ethanol. The primary clinical effect observed was transient sedation without respiratory compromise or cardiac dysrhythmia. Further evidence is needed, but this case suggests that even large overdoses of cariprazine may be managed conservatively in the absence of other complications, supporting a cautious but noninvasive approach in similar presentations."

Journal • Anesthesia • Bipolar Disorder • Borderline Personality Disorder • CNS Disorders • Mood Disorders • Personality Disorder • Psychiatry • Schizophrenia

Real-World Assessment of Healthcare Resource Utilization-Defined Manic and Depressive Events Among Patients with Bipolar I Disorder Treated with Cariprazine Versus Aripiprazole. (PubMed, Adv Ther) - "In this real-world analysis, overall rates of HRU-defined manic and depressive events were significantly lower for cariprazine versus aripiprazole, demonstrating the relative real-world value of cariprazine versus aripiprazole, and underscoring the potential HRU benefits of cariprazine's full-spectrum efficacy."

HEOR • Journal • Real-world evidence • Bipolar Disorder • CNS Disorders • Depression • Psychiatry

Partial Dopamine Agonists and Gambling Disorder: A Comprehensive Review and Clinical Implications. (PubMed, J Clin Psychopharmacol) - "The data presented suggest a clear relationship between aripiprazole and gambling behaviour, although more research is needed on this topic. Clinicians should be aware of the risk of gambling associated with partial dopamine agonists, and should therefore monitor the occurrence of gambling behaviour when introducing this drug, because patients may be reluctant to disclose it voluntarily."

Journal • Bipolar Disorder • CNS Disorders • Mood Disorders • Psychiatry • Schizophrenia

Evidence based interventions for bipolar disorder across phases and age groups: living umbrella review, evaluation, analysis, and communication hub (U-REACH) project. (PubMed, BMJ) - "The EBI-BD tool can help clinicians make evidence based, personalised treatment decisions for bipolar disorder. This resource can inform clinical guidelines and provides a foundation for continuously improving bipolar disorder care as new evidence emerges."

Journal • Review • Bipolar Disorder • CNS Disorders • Depression • Mood Disorders • Psychiatry

Systematic review and network meta-analysis of the efficacy, safety and tolerability of xanomeline plus trospium chloride compared with eight oral antipsychotics for the acute treatment of schizophrenia. (PubMed, J Comp Eff Res) - "KarXT was associated with greater odds of clinical response (≥30% improvement in PANSS total score) than aripiprazole (odds ratio [OR]: 1.85; 95% credible interval [CrI]: 1.11, 3.11), brexpiprazole (OR: 2.23; 95% CrI: 1.34, 3.83) and cariprazine (OR: 2.05; 95% CrI: 1.19, 3.57); improved change from baseline (CFB) PANSS positive symptoms score versus brexpiprazole; improved CFB CGI-S score against aripiprazole, brexpiprazole, cariprazine and olanzapine; reduced odds of clinically significant (≥7%) weight gain over all comparators except clozapine (no data); improved CFB weight against brexpiprazole, clozapine, olanzapine, quetiapine and risperidone; and greater odds of all-cause discontinuation than aripiprazole, brexpiprazole, clozapine, lumateperone, olanzapine, quetiapine and risperidone. In this NMA, for patients receiving acute treatment for schizophrenia, KarXT compared favorably with second-generation antipsychotics on key efficacy endpoints and in terms of..."

Journal • Retrospective data • Anesthesia • CNS Disorders • Psychiatry • Schizophrenia

Reappraising lithium, triiodothyronine and second-generation antipsychotic augmentation treatment for major depression: a systematic review and meta-analysis with bias-adjustment analyses. (PubMed, BMJ Ment Health) - "The certainty and robustness of evidence for lithium and T3 augmentation remained limited. Evidence for T3 was sparse and did not show a significant advantage over control, while interpretation of the lithium findings is further constrained by the fact that most trials were conducted before treatment-resistant depression was more operationally defined in contemporary research. SGAs with TSA-supported benefits (aripiprazole, quetiapine, brexpiprazole and cariprazine) may be prioritised, pending individual patient considerations."

Clinical • Journal • Retrospective data • Review • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Psychiatry

Cariprazine as a candidate for drug repurposing in anorexia nervosa: a mechanistic hypothesis grounded in neuroimaging evidence. (PubMed, Front Pharmacol) - "Multimodal neuroimaging has now revealed a coherent neurobiological architecture: functional MRI documents blunted ventral striatal and amygdalar responses to food, alongside excessive prefrontal-cingulate engagement; PET corroborates trait-level reductions in 5-HT2A binding, elevations in 5-HT1A binding across cingulate, frontal, parietal, temporal, and dorsal raphe regions, and compensatory upregulation of D2/D3 receptors in the anteroventral striatum; SPECT identifies persistent temporal and cingulate hypoperfusion; and EEG reveals attenuated P300 amplitudes, delayed N2 latencies, and parieto-occipital theta hyperarousal. Furthermore, cariprazine's favorable metabolic profile (number needed to harm for clinically significant weight gain of 34 versus 6 for olanzapine) renders its safety burden meaningfully lower than that of currently used agents. In summary, the receptor pharmacology of cariprazine maps with notable specificity onto the neuroimaging-defined..."

Journal • Anorexia • CNS Disorders • Mental Retardation • Mood Disorders • Psychiatry

Efficacy, acceptability, and related outcomes of pharmacological interventions for acute bipolar mania: a systematic review and dose-related network meta-analysis across different age groups. (PubMed, J Affect Disord) - "Our findings are consistent with previous NMAs and current guidelines, expanding the current knowledge base while concurrently appraising different drugs, doses, and age groups."

Journal • Retrospective data • Review • Bipolar Disorder • CNS Disorders • Mood Disorders • Pediatrics • Psychiatry

Dopamine D3 receptor blockade restores hippocampal synaptic plasticity and rescues memory deficits in Alzheimer's disease mouse models. (PubMed, Front Aging Neurosci) - "Pharmacological treatments included the selective D3R antagonist NGB-2904 and cariprazine, a clinically approved antipsychotic with high affinity for D3Rs...Together, these findings demonstrate that D3R-targeting compounds rescue synaptic plasticity and memory deficits in two mechanistically distinct AD models. These results support a role for dopaminergic signaling in early synaptic dysfunction and highlights D3R modulation as a relevant pathway for further investigation in AD-related cognitive impairment."

Journal • Preclinical • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Mood Disorders • Psychiatry

Adjunctive Pharmacotherapy for Major Depressive Disorder with Anxiety Symptoms: from Monoamines to Recent Clinical Evidence. (PubMed, CNS Drugs) - "Reviewed treatments included atypical antipsychotics (aripiprazole, brexpiprazole, olanzapine, quetiapine XR, risperidone, cariprazine), bupropion, ketamine/esketamine, lithium, mirtazapine/mianserin, modafinil, and triiodothyronine...Aripiprazole, brexpiprazole, quetiapine XR, and ketamine/esketamine have been shown to improve depression and/or anxiety symptoms in patients with MDD with anxiety symptoms, although evidence is mainly short-term and derived from exploratory post hoc analyses of trials not designed to assess anxiety outcomes. Treatment decisions for patients with MDD with anxiety symptoms should be based on robust clinical data, and there is an unmet need for prospective clinical trials with anxiety-specific endpoints in this patient population."

Journal • Review • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Psychiatry

A Study to Investigate Pharmacokinetics, Safety, and Tolerability of B2227 Extended-Release Injectable Suspension and Vraylar in Participants With Schizophrenia (clinicaltrials.gov) - P2/3 | N=84 | Not yet recruiting | Sponsor: Bostal Drug Delivery Co., Ltd

New P2/3 trial • CNS Disorders • Psychiatry • Schizophrenia

Cardiovascular pharmacology of dopaminergic agents in humans: a review. (PubMed, Clin Auton Res) - "The cardiovascular response to dopaminergic agents depends on receptor selectivity, intrinsic activity, and baroreflex integrity. The discrepancy between murine-knockout-predicted hypertension and human pharmacological neutrality with antagonists, and the hypertensive effects of dopamine D1 positive allosteric modulators, represent key unresolved questions."

Journal • Review • Cardiovascular • CNS Disorders • Hypertension • Hypotension • Mental Retardation • Movement Disorders • Parkinson's Disease • Psychiatry

Longitudinal PET Imaging of Antipsychotic Binding to the Dopamine-3 Receptor in Schizophrenia (clinicaltrials.gov) - P1 | N=100 | Not yet recruiting | Sponsor: New York State Psychiatric Institute

New P1 trial • CNS Disorders • Psychiatry • Schizophrenia • Schizophreniform Disorder

Extrapolating Efficacy of Cariprazine to Pediatric Schizophrenia and Bipolar Mania Through Population Pharmacokinetic Analysis. (PubMed, J Clin Pharmacol) - "Body weight did not meaningfully affect total cariprazine exposure and analyses did not support weight-based dosing in 10-12 year olds. This PK analysis supported the FDA approvals of cariprazine for the treatment of SCZ and BPM in pediatric patients by identifying efficacious doses for each indication based on efficacy extrapolation."

Journal • PK/PD data • Bipolar Disorder • CNS Disorders • Mood Disorders • Pediatrics • Psychiatry • Schizophrenia

Bioequivalence Study to Compare Cariprazine 1.5 mg Hard Capsules (1.5 mg Cariprazine Hydrochloride) Versus Reagila 1,5 mg Hartkapseln (Hard Capsules) (Cariprazine) (clinicaltrials.gov) - P1 | N=32 | Completed | Sponsor: Humanis Sagl?k Anonim Sirketi

New P1 trial • CNS Disorders • Psychiatry • Schizophrenia

Gender-specific symptom outcomes on cariprazine treatment: a 12-month naturalistic longitudinal follow-up study in schizophrenia. (PubMed, Front Psychiatry) - "Cariprazine exhibited significant efficacy in both sexes, with no significant differences between men and women despite a gender specific response profile emerged. Additional studies are needed to further investigate the efficacy profile and long-term outcome of cariprazine treatment by gender."

Journal • CNS Disorders • Psychiatry • Schizophrenia

What to do in the case of a failed first antidepressive trial? To switch or to augment? (PubMed, Psychiatr Hung) - "In the case of bipolar depression (either as a part of syndromal bipolar I or II disorder or a subsyndromal manifestation) antidepressant mono therapy should be avoided and, instead of it, the administration of a mood stabilizer (primarily lithium and lamotrigine) or certain atypical antipsychotics (preferably quetiapine, aripiprazole and cariprazine) is recommended...After the first failed antidepressant trial, augmentation with lithium, lamotrigine, or anti psychotics is recommended at first, and if this is not successful switching the antidepressant is recommended. Keywords: antidepressants; augmentation, treatment resistance; bipolar disorder; bipolar spectrum; switch the anti depressant, unipolar major depressive disorder."

Journal • Review • Bipolar Disorder • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Psychiatry