What should I do if I develop a burning sensation in my hands, feet, or chest while taking Caplyta (lumateperone)?

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Last updated: February 13, 2026View editorial policy

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Burning Sensation in Extremities and Chest While Taking Caplyta

Stop Caplyta immediately and contact your prescribing physician urgently, as burning sensations in the hands, feet, and chest are not recognized adverse effects of lumateperone and may represent a serious unrelated medical condition requiring prompt evaluation.

Why This Symptom Pattern Is Concerning

The burning sensation you describe does not match the established safety profile of Caplyta (lumateperone). In clinical trials and pooled safety analyses, the most common adverse effects were:

  • Sedation (24.1% vs 10% placebo) 1
  • Dry mouth (5% vs 2.2% placebo) 1
  • Somnolence, fatigue, and constipation 1
  • Headache, diarrhea, and weight decrease in long-term studies 1

Notably absent from all published lumateperone trials are reports of burning sensations, paresthesias, or neuropathic pain in the extremities or chest 1, 2, 3.

Critical Differential Diagnoses to Rule Out

Your symptom pattern—burning in hands, feet, AND chest—raises concern for several potentially serious conditions that require immediate medical evaluation:

1. Small Fiber Neuropathy

  • Presents as painful burning sensation in feet and hands 4
  • Can cause lancinating pain potentiated by pin-prick testing 4
  • Decreased pain and temperature sensation in affected areas 4
  • This is NOT caused by antipsychotics like Caplyta

2. Erythromelalgia

  • Episodic burning pain with erythema and warmth of extremities 4
  • Feet and hands most commonly affected 4
  • Pain can be severe enough to alter lifestyle 4
  • Associated with myeloproliferative disorders in secondary cases 4
  • Responds to low-dose aspirin (81 mg/day) within hours if related to platelet dysfunction 4

3. Cardiovascular Emergency (Chest Involvement)

  • Burning chest sensation requires urgent cardiac evaluation
  • Rule out acute coronary syndrome, especially with concurrent extremity symptoms
  • Do not attribute chest burning to a psychiatric medication without excluding cardiac causes

4. Tick-Borne Illness (Rocky Mountain Spotted Fever)

  • If you have fever, headache, or recent tick exposure with palmar/plantar symptoms 5, 6
  • Mortality rate 5-10% if untreated; requires immediate doxycycline 5, 6
  • Cannot be distinguished from other serious infections on clinical grounds alone 5

Immediate Action Steps

  1. Discontinue Caplyta and contact your prescribing psychiatrist today

  2. Seek emergency evaluation if:

    • Chest burning is accompanied by shortness of breath, diaphoresis, or radiation to jaw/arm
    • You have fever, severe headache, or appear systemically ill
    • Symptoms are rapidly worsening
  3. Schedule urgent evaluation with your primary care physician to assess for:

    • Neurological examination for small fiber neuropathy 4
    • Complete blood count and peripheral smear (to exclude myeloproliferative disorders) 4
    • Cardiovascular assessment if chest symptoms persist
    • Tick exposure history and consideration of empiric doxycycline if indicated 5, 6

Why Lumateperone Is Unlikely the Cause

Lumateperone has demonstrated a favorable safety profile distinct from other antipsychotics:

  • No significant association with extrapyramidal symptoms (EPS) 1, 2
  • No significant weight gain or metabolic syndrome 1, 2
  • Improvements in metabolic parameters when switched FROM other antipsychotics TO lumateperone 1
  • Lower treatment-emergent adverse event discontinuation rates than risperidone 1

The mechanism of action—modulating serotonin, dopamine, and glutamate neurotransmission with anti-inflammatory properties 7, 8—does not explain peripheral or central burning sensations.

Common Pitfall to Avoid

Never attribute new neurological symptoms to a psychiatric medication without excluding serious medical causes first 5, 6. The combination of extremity burning AND chest symptoms is particularly concerning and demands comprehensive medical evaluation beyond simply discontinuing the medication.

Your symptoms may represent a coincidental medical condition unrelated to Caplyta that requires specific treatment—delaying evaluation could result in preventable morbidity.

References

Research

Lumateperone for the Treatment of Schizophrenia.

Psychopharmacology bulletin, 2020

Research

Lumateperone: A Novel Antipsychotic for Schizophrenia.

The Annals of pharmacotherapy, 2021

Research

Lumateperone: New Drug or Same Old Drug With a New Dress?

Journal of psychosocial nursing and mental health services, 2020

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Diagnosis and Treatment of Descamative Lesions on Palms, Soles, and Face

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Guideline

Hyperkeratosis and Palmoplantar Keratoderma Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Research

Lumateperone Normalizes Pathological Levels of Acute Inflammation through Important Pathways Known to Be Involved in Mood Regulation.

The Journal of neuroscience : the official journal of the Society for Neuroscience, 2023

Research

Lumateperone-mediated effects on prefrontal glutamatergic receptor-mediated neurotransmission: A dopamine D1 receptor dependent mechanism.

European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology, 2022

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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