Why Do I Keep Seeing TV Commercials for Caplyta?
Is anyone else seeing a lot of commercials for Caplyta these days? What’s all the fuss about? In December 2021, the FDA approved the medication lumateperone, Caplyta, for the treatment of both bipolar I and bipolar II depression. Though quetiapine (Seroquel) also has some evidence for treating bipolar II depression, Caplyta is the FIRST with full FDA approval to treat this condition.
Patients with bipolar II are estimated to spend about 50% of their lives battling depression; and are also more likely to have co-occurring difficulties with other conditions such as OCD, ADHD, addiction, PTSD, eating disorder or personality disorders. Bipolar II is thought to affect about 5% of people.
The bipolar medications are well known to cause many side effects. This new medication, Caplyta, however appears to be tolerable. In research studies, Caplyta is shown to have less weight gain, blood sugar elevations and cholesterol elevations compared to some of the other medications on the market.
Treating bipolar disorder can be tricky, as we are actually trying to treat several different aspects of the condition. For people with bipolar disorder, they experience episodes of depression, mania or hypomania, and of course times of feeling well. That means that we need medications that both treat AND prevent mania, as well as treat AND prevent depression. So for example, if someone is depressed, we need a medication to both resolve the depression, and prevent it from occurring again. If someone is experiencing hypomania, we need a medication that will treat the hypomania AND prevent it from occurring again. If someone is well, we want to keep them well. Are you following me?
A true manic episode for someone with bipolar I can be absolutely devastating in someone’s life. Someone with bipolar I will likely need to take anti-manic medications life long.
Let’s review some of the signs and symptoms of mania:
· Decreased need for sleep
· Excessive talking
· Racing thoughts
· Distractibility
· Excessive Self Esteem
· Involvement in activities that may have painful consequences (such as excessive spending or sexual indiscretions)
· Euphoric or irritable mood
· Psychosis
· Symptoms are severe enough that a person may need to be hospitalized
However, in those with bipolar II, people experience hypomanic states, not manic states. Hypomanic states are less severe. They are also less frequent. It is estimated that those with bipolar II, will spend about 4% of their lifetime in a hypomanic or mixed episode. However, remember that earlier I said people with bipolar II may spend up to 50% of their lifetime struggling with depression. One could argue that selecting an “anti depression” medication may be much more important for people with bipolar II disorder. Before Capylta, Seroquel had the most evidence for treatment of bipolar II depression. Though a good medication, Seroquel is known to cause weight gain and is more likely to cause a movement condition called tardive dyskinesia.
To be complete, there are other medications on the market. Other medicines used to treat depression in bipolar disorder are lamotrigine, Latuda, Vyralar, lithium, and the olanazapine-fluoxetine combination. Thus far however, these medications appear to have more evidence supporting treatment of bipolar I depression, rather than bipolar II depression.
The US population is estimated to be about 331 million people, thus approximately 16.5 million people may be currently suffering with bipolar II disorder. This new medication may offer hope for those battling bipolar II depression. (FYI, this medication is also indicated for bipolar I depression). For the record, I have no commercial interests or investments in the medication Caplyta! Also, this article is intended to be educational, not a substitute for medical advice.
If you, or someone you know is struggling with bipolar depression, consider reaching out to a psychiatrist to determine what treatments would be most appropriate for you.
If you have any questions, contact me: here
