bekhterevОбозрение психиатрии и медицинской психологии имени В.М.БехтереваV.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY2313-70532713-055XV. M. BEKHTEREV NATIONAL RESEARCH MEDICAL CENTER FOR PSYCHIATRY AND NEUROLOGY OF THE RUSSIAN FEDERATION MINISTRY OF HEALTH10.31363/2313-7053-2026-2-1327bekhterev-1386Research ArticleВ ПОМОЩЬ ПРАКТИКУЮЩЕМУ ВРАЧУGUIDELINES FOR THE PRACTITIONERКлинический случай применения карипразина у пациента с биполярным аффективным расстройством и низкой приверженностью к терапииCase Report: Cariprazine Use in the Management of Bipolar Disorder with Non-compliancehttps://orcid.org/0000-0003-2148-297XСчастныйЕ. Д.SchastnyyE. D.

Счастный Евгений Дмитриевич — доктор медицинских наук, профессор, руководитель отделения аффективных состояний

Evgeny D. Schastnyy

evgeny.schastnyy@gmail.comhttps://orcid.org/0000-0001-5112-2188УкраинцевИ. И.UkraintsevI. I.

Украинцев Игорь Иванович — кандидат медицинских наук , ассистент кафедры психиатрии, наркологии и психотерапии

Igor I. Ukraintsev

garic58garic@yandex.ruНаучно-исследовательский институт психического здоровья, Томский национальный исследовательский медицинский центр Российской академии наукРоссияMental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of SciencesRussian FederationСибирский государственный университетРоссияSiberian State UniversityRussian Federation202628052026602109113Copyright © Счастный Е.Д., Украинцев И.И., 20262026Счастный Е.Д., Украинцев И.И.Schastnyy E.D., Ukraintsev I.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bekhterevreview.com/jour/article/view/1386

Представлен сложный для реабилитации клинический случай пациентки с биполярным аффективным расстройством (БАР). В описанном случае подробно описано начало заболевания, дальнейшая его динамика, персонифицированный подбор терапии с последующим назначением карипразина, на фоне которого повысилась комплаентность пациентки. Интерес представленного случая для профессионального рассмотрения и обсуждения обусловлен доказанной практическим путем эффективностью применению карипразина при низкой степени соблюдения пациентом врачебных рекомендаций, а именно побочные эффекты препаратов и сложные схемы профилактического лечения.

This article presents a challenging rehabilitation case of a female patient with bipolar disorder (BD). The described case details the onset of the disease, its subsequent progression, and personalized therapy selection, culminating in the prescription of cariprazine, which improved the patient’s compliance. The significance of this case for professional discussion lies in the empirically demonstrated efficacy of cariprazine in patients with low adherence to medical recommendations, particularly due to side effects of medications and complex prophylactic treatment regimens.

карипразинбиполярное аффективное расстройствоотсутствие комплаентностиcariprazinebipolar disordernon-complianceИсследование осуществлено в соответствии с бюджетным финансированием госзадания НИИ психического здоровья № 075-00491-26-00 в рамках комплексной темы НИР «Персонализированная терапия больных расстройствами шизофренического и аффективного спектра на основе клинически верифицированных констелляций маркеров их морфологического, биохимического и когнитивного фенотипов» (номер госрегистрации 126022417834-4. Протокол ЛЭКа № 189/3.2025 от 9 декабря 2025 года.The study was carried out in accordance with the budgetary financing of the state assignment of the Mental Health Research Institute No. 075-00491-26-00 as part of the complex research topic «Personalized Therapy for Patients with Schizophrenic and Affective Spectrum Disorders Based on Clinically Verified Constellations of Markers of Their Morphological, Biochemical, and Cognitive Phenotypes» (registration number 126022417834-4. Protocol of the LEC No. 189/3.2025 dated December 9, 2025.ReferencesКибитов АО, Шумская ДС, Пинахина ДВ. и др. Специфические метаболические и воспали тельные профили пациентов с гипергликемией при биполярном аффективном расстройстве, рекуррентной депрессии и шизофрении: результаты трансдиагностического исследования. Сибирский вестник психиатрии и наркологии. 2025;4(129): 43-56.Kibitov AO, Shumskaia DS, Pinakhina DV. et al. Specific metabolic and inflammatory profiles of patients with hyperglycemia in bipolar affective disorder, recurrent depression and schizophrenia: results of a transdiagnostic study. Siberian Herald of Psychiatry and Addiction Psychiatry. 2025; 4 (129): 43-56. https://doi.org/10.26617/1810-3111-2025-4(129)-43-56Arvilommi P, Pallaskorpi S, Linnaranta O, et al. Long-term work disability due to type I and II bipolar disorder: findings of a six-year prospective study. Int J Bipolar Disord. 2022;10(1):19. https://doi.org/10.1186/s40345-022-00264-6Arvilommi P, Pallaskorpi S, Linnaranta O, et al. Long-term work disability due to type I and II bipolar disorder: findings of a six-year prospective study. Int J Bipolar Disord. 2022;10(1):19. https://doi.org/10.1186/s40345-022-00264-6Fountoulakis KN, Ioannou M, Tohen M, et al. Antidepressant efficacy of cariprazine in bipolar disorder and the role of its pharmacodynamic properties: A hypothesis based on data. Eur Neuropsychopharmacol. 2023;72:30–39. https://doi.org/10.1016/j.euroneuro.2023.03.009Fountoulakis KN, Ioannou M, Tohen M, et al. Antidepressant efficacy of cariprazine in bipolar disorder and the role of its pharmacodynamic properties: A hypothesis based on data. Eur Neuropsychopharmacol. 2023;72:30–39. https://doi.org/10.1016/j.euroneuro.2023.03.009Grande I, Goikolea M, de Dios C, et al. Occupational disability in bipolar disorder: analysis of predictors of being on severe disablement benefit (PREBIS study data). Acta Psychiatr Scand. 2013;127 (5):403-411. https://doi.org/10.1111/acps.12003Grande I, Goikolea M, de Dios C, et al. Occupational disability in bipolar disorder: analysis of predictors of being on severe disablement benefit (PREBIS study data). Acta Psychiatr Scand. 2013;127 (5):403-411. https://doi.org/10.1111/acps.12003Hong J, Reed C, Novick D, et al. Clinical and economic consequences of medication non adherence in the treatment of patients with a manic/mixed episode of bipolar disorder: results from the European mania in bipolar longitudinal evaluation of medication (EMBLEM) study. Psychiatry Res. 2011;190:110–114. https://doi.org/10.1016/j.psychres.2011.04.016Hong J, Reed C, Novick D, et al. Clinical and economic consequences of medication non adherence in the treatment of patients with a manic/mixed episode of bipolar disorder: results from the European mania in bipolar longitudinal evaluation of medication (EMBLEM) study. Psychiatry Res. 2011;190:110–114. https://doi.org/10.1016/j.psychres.2011.04.016Li K, Liao Y, Yang Z, et al. Case Report: Paliperidone Palmitate in the Management of Bipolar I Disorder With Non-complianceFront Psychiatry. 2021;111:529672. https://doi.org/10.3389/fpsyt.2020.529672Li K, Liao Y, Yang Z, et al. Case Report: Paliperidone Palmitate in the Management of Bipolar I Disorder With Non-complianceFront Psychiatry. 2021;111:529672. https://doi.org/10.3389/fpsyt.2020.529672Mazza M, Marano G, Traversi G, et al. Cariprazine in bipolar depression and mania: State of the art. CNS Neurol Disord Drug Targets. 2018;17(10):723–727. https://doi.org/10.2174/1871527317666180828120-256Mazza M, Marano G, Traversi G, et al. Cariprazine in bipolar depression and mania: State of the art. CNS Neurol Disord Drug Targets. 2018;17(10):723–727. https://doi.org/10.2174/1871527317666180828120-256Merikangas KR, Jin R, He JP, et al. Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Arch Gen Psychiatry. 2011;68(3):241-251. https://doi.org/10.1001/archgenpsychiatry.2011.12Merikangas KR, Jin R, He JP, et al. Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Arch Gen Psychiatry. 2011;68(3):241-251. https://doi.org/10.1001/archgenpsychiatry.2011.12Pezzin LE, Larson ER, Lorber W, et al. Music instruction intervention for treatment of posttraumatic stress disorder: a randomized pilot study. BMC Psychol. 2018;6:60. https://doi.org/10.1186/s40359-018-0274-8Pezzin LE, Larson ER, Lorber W, et al. Music instruction intervention for treatment of posttraumatic stress disorder: a randomized pilot study. BMC Psychol. 2018;6:60. https://doi.org/10.1186/s40359-018-0274-8Rybakowski JK. Mood stabilizers of first and second generation. Brain Sci. 2023;13(5):741. https://doi.org/10.3390/brainsci13050741Rybakowski JK. Mood stabilizers of first and second generation. Brain Sci. 2023;13(5):741. https://doi.org/10.3390/brainsci13050741Schaffer A., Isometsa E.T., Tondo L. et al. Epidemiology, neurobiology and pharmacological interventions related to suicide deaths and suicide attempts in bipolar disorder: part I of a report of the International society for bipolar disorders task force on suicide in bipolar disorder // Aust N Z J Psychiatry. — 2015. — No 49. — P. 785–802. https://doi.org/10.1177/0004867415594427Schaffer A., Isometsa E.T., Tondo L. et al. Epidemiology, neurobiology and pharmacological interventions related to suicide deaths and suicide attempts in bipolar disorder: part I of a report of the International society for bipolar disorders task force on suicide in bipolar disorder // Aust N Z J Psychiatry. — 2015. — No 49. — P. 785–802. https://doi.org/10.1177/0004867415594427Torres-Llenza V, Lakshmin P, Lieberman DZ. Spotlight on once-monthly long-acting injectable aripiprazole and its potential as maintenance treatment for bipolar I disorder in adult patients. Neuropsychiatr Dis Treat. 2018;14:285–292. https://doi.org/10.2147/NDT.S129559Torres-Llenza V, Lakshmin P, Lieberman DZ. Spotlight on once-monthly long-acting injectable aripiprazole and its potential as maintenance treatment for bipolar I disorder in adult patients. Neuropsychiatr Dis Treat. 2018;14:285–292. https://doi.org/10.2147/NDT.S129559

The authors declare that there are no conflicts of interest present.