PsychRounds: The Psychiatry Podcast The Antipsychotics: Cariprazine (Vraylar)
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Jan 22, 2025 Dive into the world of cariprazine, a unique antipsychotic with a notable affinity for the D3 receptor. Discover how it tackles negative symptoms of schizophrenia more effectively than some traditional treatments. Safety concerns and side effects are explored, alongside its pharmacokinetics and dosing guidelines. There's a critical look at its performance compared to risperidone and the implications of its cost in clinical practice. Join the conversation on balancing effectiveness and patient care!
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Cariprazine's Receptor Binding Profile
- Cariprazine binds strongly to various receptors, including 5HT2A, 5HT2B, 5HT1A, and D2.
- Uniquely, it binds most strongly to the D3 receptor, influencing mood, cognition, and reward.
Cariprazine Dosage Recommendations
- Consider higher cariprazine doses (3-6mg) for acute psychosis or mania.
- Lower doses (1.5-3mg) are recommended for depression, with 1.5mg as the starting dose.
Cariprazine's Adverse Effect Profile
- Cariprazine is generally well-tolerated with low risk of dystonia, Parkinsonism, or tardive dyskinesia.
- However, it has the highest akathisia risk among partial agonists, especially at doses above 3mg.