Cariprazine Shows Efficacy for Bipolar Mania With Mixed Features

The use of cariprazine significantly improved manic and depressive symptoms in patients with bipolar mania with mixed features, according to results from a study published in the Journal of Affective Disorders.

Researchers conducted a post hoc analysis, using pooled data from three double-blind, placebo-controlled, randomized studies of 1037 patients with bipolar I disorder and current mixed or manic episode. The efficacy of cariprazine (3-12 mg/d) for the improvement of manic and depressive symptoms was compared with placebo and evaluated after a 3-week treatment and 2-week follow-up period. Changes in symptoms were measured using the Young Mania Rating Scale.

After analysis, the researchers found that cariprazine significantly improved mean Young Mania Rating Scale scores vs placebo using the following criteria: Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (≥3 depressive symptoms); ≥2 depressive symptoms; and a Montgomery-Åsberg Depression Rating Scale total score ≥10.

The least-squares mean differences were −3.79 (P =.0248), −2.91 (P =.0207), and −5.49 (P <.0001) for ≥3 depressive symptoms, ≥2 depressive symptoms, and ≥10 Montgomery-Åsberg Depression Rating Scale, respectively.

One key limitation of the study was the post hoc nature of the analysis.

“More cariprazine- than placebo-treated patients met [Young Mania Rating Scale] response and remission criteria,” the researchers wrote.

“Cariprazine may represent a novel treatment option for treating mixed features associated with bipolar I disorder,” they concluded. Future studies might evaluate the efficacy of cariprazine in patients with bipolar II depression and treatment-resistant bipolar disorder.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

McIntyre RS, Masand PS, Earley W, Patel M. Cariprazine for the treatment of bipolar mania with mixed features: A post hoc pooled analysis of 3 trials. J Affect Disord. 2019;257:600-606.