Cargando…

Cariprazine as a useful treatment for patients with schizophrenia and antipsychotic-induced extrapyramidal symptoms: a case report and literature review

INTRODUCTION: The discovery of second-generation antipsychotics represented an authentic breakthrough for the management of psychotic disorders. Nevertheless, they still don’t adequately manage some aspects of these disorders, such as negative symptoms (NS), cognitive impairment, or extra-pyramidal...

Descripción completa

Detalles Bibliográficos
Autores principales: Llach, C., Ilzarbe, L., Sagué-Vilavella, M., Arbelo, N., Catalan, R., Gutierrez, F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9567779/
http://dx.doi.org/10.1192/j.eurpsy.2022.2047
_version_ 1784809485419675648
author Llach, C.
Ilzarbe, L.
Sagué-Vilavella, M.
Arbelo, N.
Catalan, R.
Gutierrez, F.
author_facet Llach, C.
Ilzarbe, L.
Sagué-Vilavella, M.
Arbelo, N.
Catalan, R.
Gutierrez, F.
author_sort Llach, C.
collection PubMed
description INTRODUCTION: The discovery of second-generation antipsychotics represented an authentic breakthrough for the management of psychotic disorders. Nevertheless, they still don’t adequately manage some aspects of these disorders, such as negative symptoms (NS), cognitive impairment, or extra-pyramidal symptoms (EPS). New-generation antipsychotics present different pharmacological mechanisms and have been reported to ameliorate these aspects. Among them, cariprazine acts as a D2/D3 partial agonist with variable affinity with serotoninergic receptors, and many studies show its efficacy for preventing and treating positive symptoms as well as for the management of NS and EPS. OBJECTIVES: To report a case of a patient diagnosed with schizophrenia with highly invalidating antipsychotic-induced EPS that remitted after switching to cariprazine, while maintaining clinical stability. To review literature about cariprazine and its relationship with NS and EPS. METHODS: We describe the case of a 66-year-old woman diagnosed with schizophrenia and under treatment with three-month injectable paliperidone 175mg. During her follow-up at outpatient clinic, she presented a progressively highly invalidating non-trembling parkinsonian syndrome attributable to medication. Paliperidone plasmatic levels were within therapeutic range. An antipsychotic switch was agreed, and cariprazine was started. RESULTS: The switch from a second-generation antipsychotic to cariprazine entailed the remission of a highly invalidating EPS while improving some of the NS and maintaining psychopathological stability. CONCLUSIONS: Assessing and differentiating NS and EPS is of an utmost importance during the follow-up of patients under antipsychotic treatment. Cariprazine is an interesting alternative when treating patients diagnosed with psychotic disorders that present mostly NS and antipsychotic-induced EPS. DISCLOSURE: No significant relationships.
format Online
Article
Text
id pubmed-9567779
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Cambridge University Press
record_format MEDLINE/PubMed
spelling pubmed-95677792022-10-17 Cariprazine as a useful treatment for patients with schizophrenia and antipsychotic-induced extrapyramidal symptoms: a case report and literature review Llach, C. Ilzarbe, L. Sagué-Vilavella, M. Arbelo, N. Catalan, R. Gutierrez, F. Eur Psychiatry Abstract INTRODUCTION: The discovery of second-generation antipsychotics represented an authentic breakthrough for the management of psychotic disorders. Nevertheless, they still don’t adequately manage some aspects of these disorders, such as negative symptoms (NS), cognitive impairment, or extra-pyramidal symptoms (EPS). New-generation antipsychotics present different pharmacological mechanisms and have been reported to ameliorate these aspects. Among them, cariprazine acts as a D2/D3 partial agonist with variable affinity with serotoninergic receptors, and many studies show its efficacy for preventing and treating positive symptoms as well as for the management of NS and EPS. OBJECTIVES: To report a case of a patient diagnosed with schizophrenia with highly invalidating antipsychotic-induced EPS that remitted after switching to cariprazine, while maintaining clinical stability. To review literature about cariprazine and its relationship with NS and EPS. METHODS: We describe the case of a 66-year-old woman diagnosed with schizophrenia and under treatment with three-month injectable paliperidone 175mg. During her follow-up at outpatient clinic, she presented a progressively highly invalidating non-trembling parkinsonian syndrome attributable to medication. Paliperidone plasmatic levels were within therapeutic range. An antipsychotic switch was agreed, and cariprazine was started. RESULTS: The switch from a second-generation antipsychotic to cariprazine entailed the remission of a highly invalidating EPS while improving some of the NS and maintaining psychopathological stability. CONCLUSIONS: Assessing and differentiating NS and EPS is of an utmost importance during the follow-up of patients under antipsychotic treatment. Cariprazine is an interesting alternative when treating patients diagnosed with psychotic disorders that present mostly NS and antipsychotic-induced EPS. DISCLOSURE: No significant relationships. Cambridge University Press 2022-09-01 /pmc/articles/PMC9567779/ http://dx.doi.org/10.1192/j.eurpsy.2022.2047 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstract
Llach, C.
Ilzarbe, L.
Sagué-Vilavella, M.
Arbelo, N.
Catalan, R.
Gutierrez, F.
Cariprazine as a useful treatment for patients with schizophrenia and antipsychotic-induced extrapyramidal symptoms: a case report and literature review
title Cariprazine as a useful treatment for patients with schizophrenia and antipsychotic-induced extrapyramidal symptoms: a case report and literature review
title_full Cariprazine as a useful treatment for patients with schizophrenia and antipsychotic-induced extrapyramidal symptoms: a case report and literature review
title_fullStr Cariprazine as a useful treatment for patients with schizophrenia and antipsychotic-induced extrapyramidal symptoms: a case report and literature review
title_full_unstemmed Cariprazine as a useful treatment for patients with schizophrenia and antipsychotic-induced extrapyramidal symptoms: a case report and literature review
title_short Cariprazine as a useful treatment for patients with schizophrenia and antipsychotic-induced extrapyramidal symptoms: a case report and literature review
title_sort cariprazine as a useful treatment for patients with schizophrenia and antipsychotic-induced extrapyramidal symptoms: a case report and literature review
topic Abstract
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9567779/
http://dx.doi.org/10.1192/j.eurpsy.2022.2047
work_keys_str_mv AT llachc cariprazineasausefultreatmentforpatientswithschizophreniaandantipsychoticinducedextrapyramidalsymptomsacasereportandliteraturereview
AT ilzarbel cariprazineasausefultreatmentforpatientswithschizophreniaandantipsychoticinducedextrapyramidalsymptomsacasereportandliteraturereview
AT saguevilavellam cariprazineasausefultreatmentforpatientswithschizophreniaandantipsychoticinducedextrapyramidalsymptomsacasereportandliteraturereview
AT arbelon cariprazineasausefultreatmentforpatientswithschizophreniaandantipsychoticinducedextrapyramidalsymptomsacasereportandliteraturereview
AT catalanr cariprazineasausefultreatmentforpatientswithschizophreniaandantipsychoticinducedextrapyramidalsymptomsacasereportandliteraturereview
AT gutierrezf cariprazineasausefultreatmentforpatientswithschizophreniaandantipsychoticinducedextrapyramidalsymptomsacasereportandliteraturereview