Cariprazine for the treatment of bipolar depression: a review

Depressive symptoms and episodes dominate the course of bipolar disorder. The morbidity of bipolar disorder is disproportionately mediated by depressive symptoms; economic costs of bipolar disorder are also disproportionately due to unremitting depressive symptoms. Relatively few treatment options have established unequivocal efficacy in the treatment of bipolar depression. Herein we review evidence regarding the efficacy of the D₃ preferring D₂/D₃ partial agonist cariprazine in the treatment of adults with bipolar depression. Areas covered: Randomized controlled trials that sought to determine the efficacy, tolerability, and safety of cariprazine in adults with bipolar I depression. Expert opinion: The available evidence from clinical trials indicates that cariprazine is effective at treating bipolar depression wherein treatment for bipolar depression remains an unmet need in bipolar disorder. Cariprazine has demonstrated good tolerability and safety profiles in bipolar disorder. Furthermore, cariprazine may be effective in improving both anhedonia and cognitive dysfunction. Long term prevention studies in bipolar depression, as well as separate studies evaluating efficacy in adults with bipolar II depression, are needed.