Table 1.

Cariprazine case reports.

Sanders and Miller (65)
Age	51
Gender	Male
Problem	Bipolar I disorder with alcohol use and cocaine craving
Cariprazine's effect	Reduced substance use, craving, and improved mood symptoms
Short description	The patient had failed multiple medication trials (including risperidone, paliperidone, aripiprazole, bupropion SR, carbamazepine, lamotrigine, and lithium) for treatment of bipolar I disorder symptoms. When he got enrolled in a cariprazine (monotherapy) trial, he was suffering from alcohol abuse and craving cocaine. The transformation of his appearance and presentation was remarkable. He seemed well-groomed unlike during the previous appointments, as well as he reported a lowered urge to drink excessively or use drugs and he was in a stable mood. He stopped using illicit drugs and his drinking behavior has continuously declined, he is now abstinent
Age	20
Gender	Female
Problem	Bipolar I disorder, ADHD, alcohol, and cannabis use
Cariprazine's effect	Improved mood and behavior symptoms, reduced substance use, enhanced overall functioning
Short description	Besides the bipolar I disorder diagnosis, the patient suffered from ADHD, alcohol, and cannabis use as well. Several medications had been tried to mitigate her symptoms of depression, irritability, distractibility, and agitation with little success Cariprazine was started as an add-on treatment at 1.5 mg/day for 3 weeks without improvement; then it was increased to 3 mg/day. Her medication regimen at that time included quetiapine 25 mg/day at bedtime, clonazepam 0.5 mg twice daily at bedtime, and methylphenidate XR 72 mg daily. After 3 weeks on 3 mg cariprazine, she presented with significant improvement—no restlessness, good eye contact, organized thought processes, respectful of her mother's input, and most remarkably she was substance-free. She agreed to random urine toxicology screens, both of which were negative. Following several months of substance abstinence and respectful behavior toward her family, her parents allowed her to return to live at their home. She has been free of substance abuse for 27 months, she continues to function well, her symptoms remain improved, and she recently graduated at the top of her class in an aesthetician training program and has passed all of her state boards
Age	54
Gender	Male
Problem	Bipolar I disorder, alcohol use
Cariprazine's effect	Improved mood and behavior symptoms, reduced substance use, and enhanced overall functioning
Short description	Although the patient and his wife run their own business, he was functionally disabled by his comorbid bipolar I disorder and alcohol use disorder. At the time of his initial presentation, he was taking quetiapine, lithium, lamotrigine, bupropion, duloxetine, omega-3 fatty acids, and gabapentin. Subsequent medication trials included various combinations of lurasidone, olanzapine, methylphenidate, and asenapine. Although there was some benefit for his depression, his excessive alcohol use persisted. After the initiation of cariprazine as add-on treatment to his current regimen, he reported a dramatic decline in alcohol-craving and eventually restricted his alcohol intake to 1–2 drinks on holidays or special occasions only. He was then tapered off his previous medications, and he is now stable and functioning well on cariprazine and quetiapine
Ricci et al. (66)
Age	21
Gender	Male
Problem	Methamphetamine-induced psychosis
Cariprazine's effect	Improved mood and behavior symptoms, reduced substance use, and enhanced overall functioning
Short description	The patient progressed from occasional methamphetamine use at the age of 23 to daily use by the age of 24. He was admitted to the hospital after presenting with persistent visual and auditory hallucination, suspiciousness and social withdrawal, with symptoms remaining after ceasing methamphetamine use. He developed depressive, negative, and cognitive symptoms and suicidal thoughts. After his hospital admission, he received olanzapine with no improvement, followed by risperidone which improved depressive symptoms. He then received cariprazine (starting dose of 1.5 mg/day for 3 days, then 3 mg/day between day 4 and 12, then 4.5 mg/day from day 13 onwards) and benzodiazepines for insomnia. Two weeks of cariprazine treatment yielded an improvement in paranoid and hallucinatory symptoms, and in social functioning, resulting in his discharge. At week 16 of his treatment, his scores on the negative and positive subscales of the Positive and Negative Syndrome Scale (PANSS) were reduced by 61.7 and 69.9%. The patient regained his baseline level of social and occupational functioning, and reported a decrease in methamphetamine use and craving. Cariprazine dose was then reduced to 3 mg/day, and the improvement in symptoms was maintained during the treatment period. The patient remains on cariprazine monotherapy and during the treatment period, he remained free of psychotic symptoms and abstinent from methamphetamine