From the Research
The conversion standards for Saphris (asenapine) and Caplyta (lumateperone) are not well-established through direct equivalency studies, but a general approach is to discontinue Saphris and start Caplyta at its standard dose of 42 mg once daily with food, or discontinue Caplyta and start Saphris at 5 mg twice daily sublingually, which can be adjusted to 10 mg twice daily if needed, as supported by studies such as 1 and 2. When switching between these medications, it is essential to consider their different mechanisms of action, with Saphris being a second-generation antipsychotic that blocks multiple receptors including dopamine D2 and serotonin 5-HT2A, and Caplyta having a unique receptor profile with preferential action at serotonin receptors and lower D2 occupancy, as described in 3 and 2. Close monitoring is crucial during the transition period to manage symptom control and side effects, and dosage adjustments may be necessary based on individual patient response, with a cross-titration approach potentially being preferred in some cases, as indicated in 1. Key considerations include the potential for somnolence, constipation, and other side effects with lumateperone, as noted in 1, and the importance of maintaining stable schizophrenia symptoms, as shown in 1. Ultimately, the decision to switch between Saphris and Caplyta should be made on a case-by-case basis, taking into account the individual patient's needs and response to treatment, and considering the latest evidence from studies such as 4, which highlights the potential anti-inflammatory actions of lumateperone. Some key points to consider when converting between these medications include:
- The standard dose of Caplyta is 42 mg once daily with food, as indicated in 2
- The starting dose of Saphris is typically 5 mg twice daily sublingually, which can be adjusted to 10 mg twice daily if needed, as described in 5
- Close monitoring is essential during the transition period to manage symptom control and side effects, as emphasized in 1
- Dosage adjustments may be necessary based on individual patient response, and a cross-titration approach might be preferred in some cases, as suggested in 1.