Clinical Psychopharmacology and Neuroscience Papers in Press available online.

 
Cariprazine — an alternative treatment for clozapine-resistant schizophrenia?
Adam Montgomery 1,*, Marianna Rogowska 1, Luiz Dratcu 1
South London and Maudsley NHS Foundation Trust
Abstract
Treatment-resistant schizophrenia (TRS) poses a significant therapeutic challenge in psychiatric practice. Clozapine is recognized as a treatment of choice in TRS, however, it is not always effective in alleviating the symptoms. Additionally, clozapine therapy is associated with multiple side effects and monitoring requirements that often limit its use and negatively affect patients’ compliance with the treatment. Although clozapine augmentation options are available, there is currently no alternative monotherapy proven to be effective in treatment-resistant schizophrenia.
We present a case of a young man with TRS who failed to respond to significant trials of risperidone, aripiprazole, and clozapine while developing significant side effects of clozapine that made further treatment not only futile but also detrimental to his health. He was successfully treated with cariprazine in monotherapy which allowed him to achieve the remission of both positive and negative symptoms of psychosis, as well as an improvement in social functioning.
We hypothesize that cariprazine’s unique D3-preferring mode of action can make cariprazine an interesting, well-tolerated, and more acceptable treatment option for patients with difficult-to-treat psychotic symptoms.
Accepted Manuscript [Submitted on 2022-03-24, Accepted on 2022-05-24]