Psychiatr. praxi. 2021;22(2):84-88

Comparison of new antipsychotics (lurasidone, cariprazine and brexpiprazole) from the clinical point of view

doc. MUDr. Bc. Libor Ustohal, Ph.D.1, 2
1 Psychiatrická klinika LF MU a FN Brno
2 Ústav farmakologie a toxikologie, Farmaceutická fakulta Masarykovy univerzity, Brno

Three new antipsychotics - cariprazine, lurasidone and brexpiprazole - have been introduced to the Czech market in the past two years. This review article aims to compare them from a clinical point of view. It focuses on their basic characteristics including receptors profile, indications and efficacy, dosage including dose-response relationship and, last but not least, on their tolerability and side effects.

Keywords: brexpiprazole, cariprazine, lurasidone, efficacy, side effects, schizophrenia.

Published: July 9, 2021  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Ustohal L. Comparison of new antipsychotics (lurasidone, cariprazine and brexpiprazole) from the clinical point of view. Psychiatr. praxi. 2021;22(2):84-88.
Download citation

References

  1. Masopust J, Mohr P, Anders M. Kariprazin: profil nového antipsychotika. Psychiatrie 2019; 23: 38-46.
  2. Mohr P, Masopust J. Lurasidon: profil antipsychotika druhé generace. Psychiatrie 2019; 23(4): 197-204.
  3. Češková E. Postavení lurasidonu v léčbě schizofrenie. Farmakoterapie 2020; 16(3): 850-853.
  4. Kopeček M, Mohr P, Masopust J. Brexpiprazol: profil nového antipsychotika ze skupiny parciálních agonistů dopaminu. Psychiatrie 2020; 24: 93-102.
  5. Masopust J, Mohr P, Kopeček M. Kariprazin: antipsychotikum (nejen) pro léčbu negativních příznaků schizofrenie. Praha: Galén 2021; 159.
  6. Masopust J, Mohr P, Kopeček M. Parciální dopaminoví agonisté: stejní, nebo odlišní? Psychiatrie 2021; 25(1): 38-49.
  7. Zohar J, Blier P, Stahl S et al. Neuroscience based nomenclature. Second edition - revised 2019. Belgium: ECNP 2019: 287.
  8. Ishibashi T, Horisawa T, Tokuda K et al. Pharmacological profile of lurasidone, a novel antipsychotic agent with potent 5-hydroxytryptamine 7 (5-HT7) and 5-HT1A receptor activity. J Pharmacol Exp Ther 2010; 334: 171-181. Go to original source... Go to PubMed...
  9. Corponi F, Fabbri C, Bitter I et al. Novel antipsychotics specificity profile: A clinically oriented review of lurasidone, brexpiprazole, cariprazine and lumateperone. Eur Neuropsychopharmacol 2019; 29(9): 971-985. Go to original source... Go to PubMed...
  10. Cates LN, Roberts AJ, Huitron-Resendiz S, Hedlund PB. Effects of lurasidone in behavioral models of depression. Neuropharmacology 2013; 70: 211-217. Go to original source... Go to PubMed...
  11. Hiemke C, Bergemann N, Clement HW. Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology: Update 2017. Pharmacopsychiatry 2018; 51(1-02): 9-62. Go to original source... Go to PubMed...
  12. Kiss B, Horvath A, Nemethy Z et al. Cariprazine (RGH-188), a dopamine D(3) receptor-preferring, D(3)/D(2) dopamine receptor antagonist-partial agonist antipsychotic candidate: in vitro and neurochemical profile. J Pharmacol Exp Ther 2010; 333: 328-340. Go to original source... Go to PubMed...
  13. Girgis RR, Xu X, Gil RB et al. Antipsychotic binding to the dopamine-3 receptor in humans: A PET study with [(11)C]-(+)-PHNO. Schizophr Res 2015; 168(1-2): 373-376. Go to original source... Go to PubMed...
  14. Gross G, Wicke K, Drescher KU. Dopamine D₃ receptor antagonism--still a therapeutic option for the treatment of schizophrenia. Naunyn Schmiedebergs Arch Pharmacol 2013; 386(2): 155-166. Go to original source... Go to PubMed...
  15. Maeda K, Sugino H, Akazawa H et al. Brexpiprazole I: in vitro and in vivo characterization of a novel serotonin-dopamine activity modulator. J Pharmacol Exp Ther 2014; 350(3): 589-604. Go to original source... Go to PubMed...
  16. Fleischhacker WW. Aripiprazole. Expert Opin Pharmacother 2005; 6: 2091-2101. Go to original source... Go to PubMed...
  17. Citrome L. The ABC's of dopamine receptor partial agonists - aripiprazole, brexpiprazole and cariprazine: the 15-min challenge to sort these agents out. Int J Clin Pract 2015; 69(11): 1211-1220. Go to original source... Go to PubMed...
  18. Huhn M, Nikolakopoulou A, Schneider-Thoma J et al. Comparative efficacy and tolerability of 32 oral antipsychotics for the acute treatment of adults with multi-episode schizophrenia: A systematic review and network meta-analysis. Lancet 2019; 394: 939-951. Go to original source... Go to PubMed...
  19. Harvey PD, Siu CO, Ogasa M, Loebel A. Effect of lurasidone dose on cognition in patients with schizophrenia: post-hoc analysis of a long-term, double-blind continuation study. Schizophr Res 2015; 166(1-3): 334-338. Go to original source... Go to PubMed...
  20. Nasrallah HA, Cucchiaro JB, Mao Y et al. Lurasidone for the treatment of depressive symptoms in schizophrenia: analysis of 4 pooled, 6-week, placebo-controlled studies. CNS Spectr 2015; 20(2): 140-147. Go to original source... Go to PubMed...
  21. Németh G, Laszlovszky I, Czobor P et al. Cariprazine versus risperidone monotherapy for treatment of predominant negative symptoms in patients with schizophrenia: a randomised, double-blind, controlled trial. Lancet 2017; 389: 1103-1113. Go to original source... Go to PubMed...
  22. Earley W, Guo H, Daniel D et al. Efficacy of cariprazine on negative symptoms in patients with acute schizophrenia: A post hoc analysis of pooled data. Schizophr Res 2019; 204: 282-288. Go to original source... Go to PubMed...
  23. Citrome L, Durgam S, Lu K et al. The effect of cariprazine on hostility associated with schizophrenia: post hoc analyses from 3 randomized controlled trials. J Clin Psychiatry 2016; 77(1): 109-115. Go to original source... Go to PubMed...
  24. Chapel S, Chiu YY, Hsu J et al. Lurasidone Dose Response in Bipolar Depression: A Population Dose-response Analysis. Clin Ther 2016; 38(1): 4-15. Go to original source... Go to PubMed...
  25. Suppes T, Silva R, Cucchiaro J et al. Lurasidone for the Treatment of Major Depressive Disorder With Mixed Features: A Randomized, Double-Blind, Placebo-Controlled Study. Am J Psychiatry 2016; 173(4): 400-407. Go to original source... Go to PubMed...
  26. Citrome L. Brexpiprazole for schizophrenia and as adjunct for major depressive disorder: a systematic review of the efficacy and safety profile for this newly approved antipsychotic - what is the number needed to treat, number needed to harm and likelihood to be helped or harmed? Int J Clin Pract 2015; 69(9): 978-997. Go to original source... Go to PubMed...
  27. Stahl SM. Prescriber´s guide: Stahl´s essential psychopharmacology. London: Cambridge University Press 2017; 890.
  28. Mohr P, Kopeček M, Brunovský M, Páleníček T. Klinická psychofarmakologie. Praha: Maxdorf Jessenius 2017; 568.
  29. Leucht S, Crippa A, Siafis S et al. Dose-Response Meta-Analysis of Antipsychotic Drugs for Acute Schizophrenia. Am J Psychiatry 2020; 177(4): 342-353. Go to original source... Go to PubMed...
  30. Keks N, Hope J, Schwartz D et al. Comparative Tolerability of Dopamine D2/3 Receptor Partial Agonists for Schizophrenia. CNS Drugs 2020; 34(5): 473-507. Go to original source... Go to PubMed...
  31. Barton BB, Segger F, Fischer K et al. Update on weight-gain caused by antipsychotics: a systematic review and meta-analysis. Expert Opin Drug Saf 2020; 19(3): 295-314. Go to original source... Go to PubMed...
  32. Pillinger T, McCutcheon RA, Vano L et al. Comparative effects of 18 antipsychotics on metabolic function in patients with schizophrenia, predictors of metabolic dysregulation, and association with psychopathology: a systematic review and network meta-analysis. Lancet Psychiatry 2020; 7(1): 64-77. Go to original source... Go to PubMed...
  33. Taylor DM, Barnes TRE, Young AH. The Maudsley Prescribing Guidelines in Psychiatry. 13th ed. London: Wiley-Blackwell, 2018; 854.




Psychiatry for Practice

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.