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Mnesys - Pubblications

 

November 27, 2025

Efficacy of Cariprazine in the Psychosis Spectrum: A Systematic Review and Network Meta-Analysis of Randomised Controlled Trials in Schizophrenia and Bipolar Disorder



Background and Objective
Psychosis represents one of the most challenging clinical presentations in psychiatry. Schizophrenia and bipolar disorder may both present psychotic features, and cariprazine may offer improvement in the treatment and care of these conditions. Therefore, the objective of the current work was to synthesise results of efficacy for cariprazine in these disorders.

Methods
In total, five electronic databases were searched for randomized controlled trials enrolling patients across the psychosis spectrum, using the search term ‘Cariprazine’ (PubMed, Embase, clinicaltrials.gov, EUDRACT, Cochrane—last search January 2024). No filter or limits were employed. Effect sizes were extracted, by the mean difference in psychometric variables before and after the intervention (Clinical Global Impression Scale, Positive and Negative Symptom Scale, Montgomery–Asberg Depression Rating Scale, Young Mania Rating Scale, Hamilton Anxiety Rating Scale).

Results
In total, 12 studies enrolling either patients with schizophrenia or bipolar disorder were included (total n = 6477; n = 4814 patients treated with cariprazine, n = 1663 controls treated with placebo). Cariprazine was effective in reducing global clinical severity, and higher improvements were observed at increasing dosages (− 0.25 at ≤ 1.5 mg/day, − 0.45 at ≥ 3 mg/day). Cariprazine also effectively reduced psychotic total scores: − 6.74, [95% confidence interval (CI) − 8.31; − 5.17], depression: − 1.78, [95% CI − 2.54; − 1.02], mania: − 5.72, [95% CI – 6.95; – 4.49], and anxiety symptoms: – 1.24, [95% CI – 1.92; – 0.56].

Conclusions
Cariprazine was observed as efficacious across retrieved studies, offering a potential for tailored treatments across the psychosis spectrum.

Authors

Giovanni Castellini

Giovanni Castellini

Cristiano Dani

Cristiano Dani

Valdo Ricca

Valdo Ricca

Eleonora Rossi

Eleonora Rossi

Livio Tarchi

Livio Tarchi

Other Authors

Susan Bugini, Emanuele Cassioli, Stefano Lucarelli, Saverio Caini