Effect of cariprazine on metabolic parameters in patients with affective disorders: A systematic review and meta-analysis.

BACKGROUND

Cariprazine is a second-generation antipsychotic approved for treating schizophrenia, acute manic/mixed, and depressive episodes associated with bipolar I disorder, and as adjunctive treatment in major depressive disorder (MDD). Antipsychotic treatment is often associated with metabolic alterations, including weight gain, dyslipidemia, and increased risk of type 2 diabetes and cardiovascular disease.

AIMS: We conducted a systematic review and meta-analysis to synthesize study results on the effects of cariprazine on glucose and lipid homeostasis, as well as weight, in persons living with affective disorders.

METHODS

Using the Covidence platform, we included 19 studies for the systematic review and 4 randomized controlled studies for the meta-analysis. This study is registered with the International Platform of Registered Systematic Review and Meta-analysis Protocols under protocol number 2025100044. Six meta-analyses focused on patients with bipolar disorder (BD), and six meta-analyses focused on patients with MDD, evaluating changes in weight, cholesterol, and glucose for both cariprazine 1.5 and 3 mg.

RESULTS

Cariprazine showed a minimal impact on the metabolic profile in both BD and MDD. Notably, weight gain was statistically significant in both doses (i.e. 1.5, 3 mg), but in most cases not clinically meaningful. Results indicate that there was no statistically significant shift relative to placebo in fasting glucose, triglycerides, or cholesterol.

CONCLUSIONS

Results from this meta-analysis suggest that cariprazine presents a favourable metabolic profile compared to other atypical antipsychotics.