The effects of cariprazine, aripiprazole, and brexpiprazole on lipid and carbohydrate metabolism and weight gain: a narrative review

A number of metabolic disorders (hyperglycemia, dyslipidemia, obesity) are an urgent problem in psychiatry due to the fact that patients with severe mental disorders have a higher risk of developing them, which is associated both with the impact of psychopharmacotherapy and with individual characteristics of the patient and requires a personalized approach in the selection of treatment. Cariprazine, aripiprazole and brexpiprazole, are allocated to a separate class of III generation antipsychotics, and belong to partial dopamine agonists. This class of drugs has a lower risk of developing metabolic complications, but it also has a pronounced heterogeneity in terms of safety and efficacy, which necessitates further, more targeted studies of their metabolic effects. Material and methods: the analysis of the features of the development of hyperglycemia, weight gain, dyslipidemia in patients receiving aripiprazole, brexpiprazole, aripiprazole according to the results of data from randomized controlled studies. Results and discussion: It was found that brexpiprazole is probably associated with a higher risk of weight gain and blood triglyceride levels, and cariprazine with a higher risk of hyperglycemia, but in general a low risk of developing metabolic effects during therapy with third-generation antipsychotics was revealed. Their favorable effect on the lipid spectrum was revealed: cariprazine leads to a decrease in LDL cholesterol, and aripiprazole and brexpiprazole - to an increase in HDL cholesterol, which generally makes them the drugs of choice for patients with an increased risk of developing metabolic disorders.

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