Expert Guidelines on the Use of Cariprazine in Bipolar I Disorder: Consensus from Southeast Asia
36
Issued Date
2025-06-01
Resource Type
eISSN
22279032
Scopus ID
2-s2.0-105007867476
Journal Title
Healthcare Switzerland
Volume
13
Issue
11
Rights Holder(s)
SCOPUS
Bibliographic Citation
Healthcare Switzerland Vol.13 No.11 (2025)
Suggested Citation
Sulaiman A.H., Amin M.M., Ang J.K., Ho R., Nik Jaafar N.R., Ng C.G., Wibowo Nurhidayat A., Paholpak P., Pariwatcharakul P., Sanguanvichaikul T., Ung E.K., Wardani N.D., Yeo B. Expert Guidelines on the Use of Cariprazine in Bipolar I Disorder: Consensus from Southeast Asia. Healthcare Switzerland Vol.13 No.11 (2025). doi:10.3390/healthcare13111304 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/110793
Title
Expert Guidelines on the Use of Cariprazine in Bipolar I Disorder: Consensus from Southeast Asia
Author's Affiliation
Universiti Malaya
Hong Kong University of Science and Technology
NUS Yong Loo Lin School of Medicine
Khon Kaen University
Universitas Diponegoro
Siriraj Hospital
Universitas Sumatera Utara
Hospital Canselor Tuanku Muhriz UKM
Universitas Islam Negeri Syarif Hidayatullah Jakarta
Faculty of Medicine and Health Sciences
Mount Elizabeth Medical Centre
Somdet Chaopraya Institute of Psychiatry
Adam Road Medical Centre
Hong Kong University of Science and Technology
NUS Yong Loo Lin School of Medicine
Khon Kaen University
Universitas Diponegoro
Siriraj Hospital
Universitas Sumatera Utara
Hospital Canselor Tuanku Muhriz UKM
Universitas Islam Negeri Syarif Hidayatullah Jakarta
Faculty of Medicine and Health Sciences
Mount Elizabeth Medical Centre
Somdet Chaopraya Institute of Psychiatry
Adam Road Medical Centre
Corresponding Author(s)
Other Contributor(s)
Abstract
Background/Objectives: Cariprazine, a D3/D2 partial agonist, is one of the few recommended treatment options for bipolar 1 disorder (BP1D) in Southeast Asia. This study aims to generate insights from leading experts on the safe and effective use of cariprazine for BP1D, specifically by formulating practical recommendations not thoroughly covered in the existing literature. Methods: A formal consensus methodology using the modified RAND/UCLA Appropriateness Method was employed to develop consensus recommendations. The methodology included a targeted literature search, creation of clinical scenarios, two rounds of rating of the appropriateness of each scenario on a nine-point Likert scale by an expert panel of psychiatrists from Southeast Asia (n = 13), and a face-to-face discussion among the expert panel between the two rounds of rating. In the absence of disagreement, scenarios were classified as appropriate (7–9), equivocal (4–6), or inappropriate (1–3) based on median scores. Clinical scenarios were subsequently converted to consensus recommendations upon approval by the expert panel. Results: Most experts recommended a 4–8-week trial of cariprazine for bipolar depression (85%) and 3–4 weeks for acute mania/mixed (71%). For longer treatment, 61.5% and 69% recommended >1 year for acute mania/mixed and bipolar depression, respectively. Cariprazine was also considered suitable as first-line therapy, including for first-episode bipolar depression (Mdn: 8, IQR: 7–9) and first-episode mania (Mdn: 8; IQR: 8–9). Conclusions: The consensus recommendations may serve as practical guidance for clinicians to make informed decisions regarding the management of adult patients with BP1D, while considering the preferences and circumstances of individual patients.