Bipolar disorder is a mood disorder that causes people to experience intense changes in mood, energy, thinking, and behavior. There are different types of bipolar disorder including bipolar I and bipolar II. Bipolar I is associated with manic episodes. Manic episodes might encompass a period of having a highly energized state and extremes in emotions, thoughts, activity, and irritability. This is so much so that it is very different from your usual self and noticeable by others. Manic episodes may sometimes lead to poor decisions leading to physical, social, or financial harm (exs. suddenly gambling or jumping off a building). Those with bipolar II experience a less extreme form of mania called hypomania and it doesn’t interfere with daily life as with bipolar I. Another key characteristic of bipolar disorder, but not always experienced by everyone with bipolar disorder is depressive episodes. Depressive episodes might lead someone to feel down, worthless, hopeless, depressed, or have a loss of interest in activities they typically do. People may experience depressive episodes with either bipolar I or bipolar II.
For those who suffer from bipolar depression, a new treatment option was approved in December 2021. Caplyta (lumateperone) was approved for treatment either alone or in combination with other treatments (lithium or valproate) for depressive episodes associated with either bipolar I or II disorder. It is also approved to treat schizophrenia. Caplyta is easy to use, it is taken as just one 42 mg pill once a day with or without food. Caplyta was shown to have a statistically significant improvement in bipolar depression during trials when used either alone or with lithium or valproate. It is not approved for use in children because the safety and effectiveness are not yet known. The most common side effects in the 6-week trials were sedation/somnolence, dizziness, nausea, and dry mouth.
There are some listed safety precautions and drug interactions that are listed on the medication guide. Taking Caplyta with certain other medications that are CYP3A4 inducers (exs. phenobarbital, phenytoin, St. John’s wort) or inhibitors (exs. Diltiazem, verapamil, erythromycin, clarithromycin, itraconazole) should be avoided. Ask your pharmacist or doctor if any of your medications fall into this category. You should also avoid using Caplyta if you have moderate to severe liver impairment. A black boxed warning for the medication is that Caplyta is not approved for treatment of dementia-related psychosis and should not be used for elderly patients with dementia-related psychosis because it may increase the risk of death. An additional black boxed warning, which typically is included for all anti-depressants, is the increased risk of suicidal thoughts and behaviors in kids and young adults. If you’re taking Caplyta or any antidepressant and experience any sudden changes in mood, behaviors, thoughts, or feelings, call your healthcare provider right away.
If your bipolar depression has been difficult to treat, and you’re looking for a new way to treat it, talk with your doctor about the risks and benefits of Caplyta for you.