Case Report: Four cases for cariprazine and alcohol use disorder.

Background: Alcohol can diminish individual health from the fetus to old age and affects a wide range of structures and processes in the central nervous system. The role of dopamine D2 and D3 receptors in addictive diseases is the subject of many years of research. Among many psychotropic medications, cariprazine actually preferentially binds to D3 receptors, and its binding is stronger than that of any other antipsychotic, and even that of dopamine itself. Some data indicate that cariprazine and its effects associated with D3 partial agonism, could improve the domain of cognitive and depressive symptoms, as well as in the sphere of motivation, reward and cravings reduction. Cases presentations: This case report describes four individual cases of patients who were alcohol addicts, with multiple hospitalizations during their treatment of dependence. All four patients were treated during the years with many different pharmacologic protocols, involving antipsychotics (olanzapine, quetiapine), mood stabilizers (carbamazepine, lamotrigine), anxiolytics (clonazepam, bromazepam), SSRI antidepressants (fluoxetine, paroxetine, escitalopram), but without achieving of the alcohol abstinence. Only by adding of cariprazine in the protocol, with almost total exclusion of other phychopharmacs, they achieved stable alcohol abstinence. Similarly, across all four cases, a marked improvement in depressive and cognitive symptoms was observed, and although each patient had been treated with antidepressants for many years, meaningful improvement occurred only after the introduction of cariprazine. Conclusion: The consistent achievement of full abstinence across all four patients suggests that it may have potential relevance in the management of alcohol use disorder (AUD). However, in the future, well conducted and highly controlled studies are needed to explore a potential cariprazine's role and its place in the management of alcohol dependence.