Cariprazine-Induced Extrapyramidal Symptoms and a Rare Downward Eye Deviation in Oculogyric Crisis: A Case Series

Cariprazine is one of the newer generation antipsychotics with dopamine receptor partial agonist activity which has been approved for management of schizophrenia and bipolar affective disorder. It is known to have lesser propensity to cause extrapyramidal adverse effects due to D2 and D3 partial agonism. We intend to disseminate our newly acquired experience regarding tolerability and the adverse effect profile of cariprazine. In this case series, we describe three cases with different symptom profiles who had experienced significant adverse drug reaction with cariprazine. We also describe a unique presentation of oculogyric crisis in the form of downward fixation of eyes as well the use of amantadine as an alternative option for the management of extrapyramidal adverse effects.