What is the other name for the antidepressant medication, such as fluoxetine (Prozac) or sertraline (Zoloft), that a patient with bipolar II disorder taking Caplyta might be prescribed?

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Alternative Names for Antidepressants in Bipolar II Disorder

Fluoxetine is also known by its brand name Prozac, and sertraline is also known as Zoloft—these are the two SSRIs with the most evidence supporting their use as monotherapy in bipolar II depression. 1, 2

Primary SSRI Options and Their Alternative Names

The second-generation antidepressants commonly used include both generic (chemical) names and brand (trade) names: 3

SSRIs (Selective Serotonin Reuptake Inhibitors):

  • Fluoxetine = Prozac 3
  • Sertraline = Zoloft 3
  • Paroxetine = Paxil 3
  • Citalopram = Celexa 3
  • Escitalopram = Lexapro 3
  • Fluvoxamine = Luvox 3

SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors):

  • Venlafaxine = Effexor 3
  • Duloxetine = Cymbalta 3

Other Second-Generation Antidepressants:

  • Bupropion = Wellbutrin 3
  • Mirtazapine = Remeron 3
  • Trazodone = Desyrel 3

Critical Context for Bipolar II Patients on Caplyta

For a patient with bipolar II disorder already taking Caplyta (lumateperone), fluoxetine monotherapy at 20 mg daily is the most evidence-based antidepressant choice, with demonstrated efficacy and a low manic switch rate of only 3.8-7.3%. 1, 2, 4

Why Fluoxetine Specifically for Bipolar II:

  • Fluoxetine monotherapy has been studied extensively in bipolar II depression with response rates of 38-48% and remarkably low hypomanic switch rates (3.8% during acute treatment, 2% during long-term therapy). 1, 2, 4

  • The manic switch rate with fluoxetine in bipolar II patients (3.8%) is not significantly different from unipolar depression patients (0.3-1%), challenging the traditional concern about antidepressant-induced mania in this population. 2

  • Fluoxetine demonstrated similar efficacy in bipolar II versus unipolar depression, with lower discontinuation rates for lack of efficacy (5% vs 12%) and similar adverse event profiles. 2

Important Safety Consideration:

Current treatment guidelines traditionally recommend mood stabilizer monotherapy or mood stabilizer plus SSRI combination for bipolar II depression due to manic switch concerns, but emerging evidence supports fluoxetine monotherapy as safe and effective with low switch rates. 1, 4 Since your patient is already on Caplyta (an atypical antipsychotic with mood-stabilizing properties), adding fluoxetine represents a rational combination approach. 5

Alternative Approved Combination:

The only FDA-approved antidepressant combination for bipolar depression is olanzapine/fluoxetine combination (brand name Symbyax), with NNT of 4-7 for response, though it carries significant weight gain risk (NNH of 6 for ≥7% weight gain). 5

References

3
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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