Using Cariprazine to guide treatment in bipolar I disorder

Early improvement in depressive or anxiety symptoms with Cariprazine predicts treatment response in both depression and anxiety, a recent study published in the 'Journal of Affective Disorders illustrated.

Mauricio Tohen and colleagues investigated whether initial positive outcomes with Cariprazine predict eventual treatment response. The assessment focused on early progress, defined as over 25% improvement by day 15 in Montgomery-Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Rating Scale (HAM-A) scores for depression studies, and by day 7 in Young Mania Rating Scale (YMRS) scores for mania studies.

Subsequent evaluation included depressive/anxiety symptom response (≥50% improvement at week 6) and manic symptom response (≥50% improvement at week 3), respectively.

Individuals having bipolar I depression who showed early improvement in MADRS scores were 4 to 6 times more likely to have MADRS or HAM-A response compared to those without initial improvement. Similarly, patients with early improvement in HAM-A scores were 3 to 4 times more likely to achieve response in MADRS or HAM-A.

A subset of patients who did not initially recover with Cariprazine with a dose of 1.5 mg given daily (20%-31%) showed a response after adjusting the dose. In patients with mania, early improvement in YMRS scores boosted the likelihood of achieving manic symptom response approximately 5 times more than those without early improvement.