Title:Cariprazine Augmentation in Treatment-Resistant Bipolar Depression:
Data from a Retrospective Observational Study
Volume: 22
Issue: 10
Author(s): Elena Teobaldi, Enrico Pessina, Azzurra Martini, Carlo Ignazio Cattaneo, Domenico De Berardis, Vassilis Martiadis, Giuseppe Maina*Gianluca Rosso
Affiliation:
- Department of Neurosciences, University of Turin, Turin 10126, Italy
- Department of Neurosciences, San Luigi Gonzaga
University Hospital, Orbassano, Turin, Italy
Keywords:
Bipolar disorder, bipolar depression, treatment-resistance, TRBD, cariprazine, hamilton depression rating scale.
Abstract:
Background: Treatment-resistant bipolar depression is one of the leading problems in psychiatry
with serious consequences on patients functioning, quality of life and resource utilization.
Despite this, there is a lack of consensus on diagnostic criteria and treatment algorithms.
Objective: The objective of the present study is to assess the acute effectiveness and tolerability of
cariprazine in the management of treatment resistant bipolar depression.
Methods: This is a four weeks retrospective multicentric observational study on patients with treatment
resistant bipolar depression receiving cariprazine in augmentation to the current treatment.
Cariprazine dosage changed during the follow-up period according to clinical judgment. Since data
followed a non-normal distribution, non-parametric tests were used to pursue the analysis. The effectiveness
of cariprazine was assessed through the mean change in Hamilton Depression rating scale
(HAM-D) scores from baseline to endpoint. For missing values, a “Last Observation Carried Forward”
approach was applied.
Results: Fifty-one patients were enrolled. Four patients (7.8%) discontinued cariprazine mainly due to
adverse events. Mean cariprazine dose was 1.7 mg/day. The mean HAM-D score decreased significantly
from baseline (T0) to week 4 (T4) at each evaluation point. Fourty-five one percent of the patients
benefited of cariprazine add-on strategy: 23.5% achieved a clinical response and 21.6% were
remitters. Among the completers, 70.6% experienced at least one adverse event. All side effects were
mild to moderate.
Conclusion: Cariprazine seems to be an effective and well tolerated option in the management of
patients with treatment resistant bipolar depression.
