Eficacia, seguridad y tolerabilidad de cariprazina en el trastorno depresivo mayor: una revisión sistemática y aspectos prácticos

Cariprazine is a new generation antipsychotic whose mechanism of action is based on partial agonism of dopamine D₂ and D₃ receptors, in addition to serotonin 5HT_1A receptors. Its use has been approved by the Spanish Agency of Medicines and Medical Devices for the treatment of schizophrenia. However, the available literature has demonstrated its efficacy in the treatment of manic, mixed, and depressive episodes of bipolar disorder, all them approved indication in the United Sattes and several other countries. Likewise, there is currently evidence regarding the clinical efficacy, safety, and tolerability of cariprazine as an adjunctive treatment in major depressive disorder, which has granted this compound the approval by the Food and Drug Administration (FDA). While three clinical trials have shown negative results, two others have observed a significant reduction in depressive and anxiety symptoms, which has also been confirmed in a long-term open-label trial. Despite presenting a favorable adverse effect profile compared to other antipsychotics, cariprazine has been associated with akathisia and restlessness. Based on current evidence, the use of cariprazine as an adjunctive treatment to antidepressants may be beneficial in major depressive disorder. Future studies may address its efficacy in monotherapy, and its role in the prevention of depressive recurrences.