Cariprazine is a dopamine D3-preferring D3/D2 receptor partial agonist in 
late-stage clinical development for the treatment of bipolar disorder 
(manic/mixed and depressive episodes), as well as for schizophrenia, and as an 
adjunctive agent for the treatment of major depressive disorder. Three phase 2 
or 3, 3-week, randomized controlled trials in bipolar mania or mixed episodes 
have been completed and reported as poster presentations or in press releases by 
the manufacturer. Superiority over placebo on the Young Mania Rating Scale total 
score was evidenced for daily doses of cariprazine 3-12 mg/day. In short-term 
randomized controlled trials, cariprazine does not appear to adversely impact 
metabolic variables, prolactin, or the electrocardiogram (ECG) QT interval. The 
most commonly encountered adverse events in the mania trials were extrapyramidal 
disorder, akathisia, insomnia, vomiting, restlessness, sedation, vision blurred, 
and pain in extremity in the phase 2 trial where this was presented in a poster, 
and akathisia, extrapyramidal disorder, tremor, dyspepsia, vomiting, dizziness, 
diarrhea, somnolence, restlessness, and pyrexia for the phase 3 trial where this 
was presented in a poster. With the exception of akathisia and extrapyramidal 
disorder, the differences in incidence versus placebo for these events were 
generally small. If approved by regulatory authorities, cariprazine would join 
aripiprazole as the second dopamine receptor partial agonist antipsychotic 
available for clinical use in persons with bipolar mania or mixed episodes. 
Cariprazine differs from aripiprazole in terms of dopamine D3 receptor 
selectivity. Further studies would be helpful to discern the distinguishing 
features of cariprazine from other antimanic agents.