Recommended Use and Dosage of Caplyta (Lumateperone)
The recommended dosage of Caplyta (lumateperone) is 42 mg administered orally once daily with or without food, with no dose titration required. 1
Indications
Caplyta (lumateperone) is FDA-approved for:
- Treatment of schizophrenia in adults
- Treatment of depressive episodes associated with bipolar I or II disorder in adults (as monotherapy or adjunctive therapy with lithium or valproate)
Dosage Guidelines
Standard Dosing
- 42 mg once daily with or without food
- No dose titration is required
Special Populations
Patients Taking CYP3A4 Inhibitors
- Strong CYP3A4 inhibitors: Reduce dose to 10.5 mg once daily
- Moderate CYP3A4 inhibitors: Reduce dose to 21 mg once daily 1
Hepatic Impairment
- Moderate or severe hepatic impairment (Child-Pugh class B or C): 21 mg once daily 1
Mechanism of Action
Lumateperone is a first-in-class agent that works through:
- Selective and simultaneous modulation of serotonin, dopamine, and glutamate neurotransmission 2
- Potential anti-inflammatory properties that may contribute to its therapeutic effects 3
Clinical Considerations
Advantages
- Favorable metabolic profile compared to many other antipsychotics
- Low risk of extrapyramidal symptoms (EPS)
- Minimal weight gain
- May improve metabolic parameters in patients switched from other antipsychotics 4
Monitoring
- Regular assessment of therapeutic response
- Monitor for common side effects including:
Contraindications and Precautions
Caplyta should be used with caution or avoided in:
- Pregnant or breastfeeding women
- Children and adolescents (safety and efficacy not established)
- Elderly patients with dementia-related psychosis (increased mortality risk)
- Patients at risk for cerebrovascular diseases
- Patients using CYP3A4 inducers (may decrease lumateperone effectiveness)
- Patients using alcohol and other sedating agents (potential additive effects) 6
Clinical Pearls
- Unlike many other antipsychotics, lumateperone has shown improvements in metabolic parameters, weight, and prolactin levels in clinical studies 4
- When switching from other antipsychotics to lumateperone, no cross-titration is required
- The unique mechanism of action makes it a valuable option for patients who have had metabolic issues or movement disorders with other antipsychotics
- Lumateperone is being investigated for other conditions including major depressive disorder 3
Remember that while lumateperone offers advantages in terms of metabolic and movement disorder side effects, individual patient factors including prior medication response, comorbidities, and potential drug interactions should guide selection.