INVESTIGATING THE SAFETY, EFFICACY, AND TOLERABILITY OF ADJUNCTIVE CARIPRAZINE TREATMENT TO PSYCHOSTIMULANTS IN ADULTS WITH ADHD: A PRELIMINARY STUDY

Background

Many patients with complex and severe ADHD experience suboptimal benefits with psychostimulant treatment and may require alternative psychotropic medications that target the remaining debilitating symptoms of ADHD. As an atypical antipsychotic acting as a partial Dopamine (DA) agonist at D2 and D3 and Serotonin (5HT) 5HT1A receptors, cariprazine may have the potential to increase DA, Noradrenergic (NA) activity and improve ADHD symptoms. Therefore, this study aimed to examine whether adjunctive treatment of cariprazine would increase the efficacy of standard psychostimulant treatment in patients with ADHD who had an inadequate response to psychostimulants alone.

Methods

Subjects (N=10) included adult psychiatric outpatients (Mage = 42.80, SD = 11.22) previously diagnosed with ADHD, with or without secondary comorbidities. Participants were administered 1.5mg of cariprazine daily for the first week of the study and flexibly titrated up to a maximum of 3mg/day.

Results

Results from paired samples t-tests showed significant improvements in BAARS-IV scores, t(9) = 2.46, p = 0.036, ASRS scores, t(9) = 1.88, p = 0.046, CGI-S scores, t(8) = 3.41, p = 0.005, visuospatial working memory, t(6) = -2.56, p = 0.021, episodic memory, t(6) = 3.09, p = 0.011, and response inhibition, t(6) = -2.53, p = 0.022, between baseline measures and post-treatment.

Discussion

Results from this preliminary study suggest adjunctive treatment of cariprazine may be efficacious in reducing residual ADHD symptoms, lessen clinical severity of global mental illness, and enhance cognitive functioning among individuals with ADHD. Thus, future studies should investigate the mechanisms underlying cariprazine treatment through the normalization of DA activity.