Cariprazine add-on in inadequate clozapine response: a report on two cases
Domenico De Berardis 1, 2*, Gabriella Rapini 1, Luigi Olivieri 1, Agostina Giardini 1, Ida De Lauretis 1, Nicola Serroni 1, Laura Orsolini 3, Michele Fornaro 4, Felice Iasevoli 4, Sabatino Trotta 5, Paolo Cottura 6, Marco Alessandrini 2, Massimo Di Giannantonio 2
1NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “G. Mazzini,” ASL 4 Teramo, Italy, 2Department of Neurosciences and Imaging, Chair of Psychiatry, University “G. D’Annunzio,” Chieti, Italy, 3School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Herts, UK, 4Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine “Federico II,” Naples, Italy, 5NHS, Department of Mental Health, Pescara, Italy, 6NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Savigliano, ASL CN 1 Cuneo, Italy
Received: October 21, 2019; Revised: November 19, 2019; Accepted: November 27, 2019; Published online: November 27, 2019.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
Cariprazine is a novel antipsychotic drug that exerts partial agonism of dopamine D2/D3 receptors with preferential binding to the D3 receptor, antagonism of 5HT2B receptors, and partial agonism of 5HT1A. Currently, cariprazine has shown clinical efficacy in patients with schizophrenia and with bipolar disorder (BD), as well as adjunctive treatment in patients with Major Depressive Disorder (MDD) and drug-resistant MDD. In the present case series, we report on two patients with treatment-resistant schizophrenia and partial response to clozapine who benefit from combination with cariprazine. The effects of cariprazine combination were remarkable also concerning the adverse metabolic effects of clozapine.
Keywords: Cariprazine, Schizophrenia, Clozapine, Resistance, Efficacy, Tolerability


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