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September 10, 2025Open Access

A Comparative Evaluation of the Efficacy and Safety Profile of Cariprazine and Olanzapine in Patients With Schizophrenia in a Tertiary Care Hospital

Key Points

Cariprazine showed significant improvement in reducing negative symptoms compared to olanzapine at six weeks.
Both cariprazine and olanzapine led to meaningful reductions in symptoms, with p-values indicating significance at <0.001.
The study utilized various assessment scales including BPRS, SAPS, and SANS, ensuring a comprehensive evaluation of patient outcomes.
Given the short follow-up period and limited sample size, further trials are necessary to validate these findings in a broader context.

Abstract

Background Schizophrenia is a chronic psychiatric disorder requiring long-term antipsychotic treatment. Cariprazine, a newer atypical antipsychotic with D2/D3 partial agonist activity, has shown promise in managing both positive and negative symptoms. This study aimed to compare the efficacy and safety of cariprazine with olanzapine in patients with schizophrenia in a tertiary care setting in India. Methods A prospective comparative study was conducted among 60 patients diagnosed with schizophrenia, allocated in equal numbers to cariprazine and olanzapine groups. Baseline and six-week assessments were performed using the Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS), and the Udvalg for Kliniske Undersøgelser (UKU) Side Effect Rating Scale. Statistical analyses included t-tests, ANOVA, and chi-square tests, with significance set at p<0.05. Results Both groups showed significant improvements from baseline on BPRS, SAPS, and SANS scores (p<0.001). At six weeks, cariprazine was more effective in reducing negative symptoms (SANS: 39.90 ± 19.25) compared to olanzapine (SANS: 55.37 ± 16.22; p=0.005). Olanzapine led to a greater reduction in positive symptoms (SAPS: 38.13 ± 18.45 vs. 45.80 ± 20.33; p=0.008). UKU scores indicated minimal adverse effects in both groups, with cariprazine showing a slightly more favorable tolerability profile (2.97 ± 3.42 vs. 3.07 ± 3.63; p<0.001). Age significantly influenced BPRS outcomes, while gender, marital status, and socioeconomic status had no significant effect. Conclusion Both cariprazine and olanzapine demonstrated comparable overall efficacy. Cariprazine showed an advantage in improving negative symptoms and exhibited a more favorable side effect profile. Given the small sample size, short follow-up period, and single-center setting, these findings should be interpreted with caution. Larger, long-term trials are needed to confirm the results.

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