Summary

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• Cariprazine (Vraylar) is a dopamine partial agonist used for its antidepressant effects, particularly in treatment-resistant depression. It has been compared with aripiprazole and brexpiprazole, showcasing effectiveness in the order of aripiprazole, brexpiprazole, then cariprazine.
• The information was derived from 26 systematic reviews/meta-analyses documents that focused on comparisons with other medications in terms of safety and effectiveness.
• Cariprazine's efficacy extends beyond treatment-resistant depression to managing schizophrenia, bipolar I disorder, including manic, mixed, and depressive episodes, as well as an adjunctive therapy for major depressive disorder (MDD).
• Compared to various atypical antipsychotics (AAPs) and mood stabilizers, cariprazine stands out due to its notable effectiveness in treating bipolar depression along with acute manic or mixed episodes while maintaining a good safety profile.
• The medication's dosage plays a crucial role when comparing it against other dopamine partial agonists and atypical antipsychotics. Side effects such as akathisia and weight gain can be mitigated by careful management of administration while achieving the desired therapeutic outcomes.
• Population types, like different ethnic groups or age brackets, have variability in their response towards this medication, which underscores the need for personalized treatment planning, especially among patients suffering from schizophrenia or bipolar disorders.
• Systematic reviews/meta-analyses highlight a comparative advantage over placebo in reducing depressive symptoms and improving remission rates regardless of the primary psychiatric diagnosis, reinforcing its significance in treating both bipolar disorder and schizophrenia.
• Clinical trials and real-world case reports support Vraylar’s safety and efficacy across various psychiatric symptoms and conditions, with early protocols especially for diagnostic differentiation between challenging cases, indicating its utility in wider scenarios.