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Caplyta vs Rexulti
Introduction
For patients with bipolar disorder, schizophrenia or depressive disorders, certain medications can significantly influence the chemical balance in the brain to manage mood fluctuations and related symptoms. Caplyta and Rexulti are such drugs that are frequently prescribed for these conditions. They each impact different neurotransmitters in the brain but both have been shown to effectively stabilize moods in patients suffering from psychiatric disorders. Caplyta is an atypical antipsychotic medication which works by acting on receptors of serotonin and dopamine, among others. Rexulti, on the other hand, is classified as a serotonin-dopamine activity modulator (SDAM), influencing primarily levels of serotonin and dopamine while also affecting noradrenaline receptors. The choice between these two medications may depend on various factors including patient's specific condition, side effect profile and potential interactions with other medications they might be taking.
What is Caplyta?
Lumateperone (the generic name for Caplyta) represents a unique addition to the class of atypical antipsychotics, which has already seen remarkable improvements with drugs like Rexulti. Lumateperone was first approved by the FDA in 2019. Caplyta works on serotonin, dopamine and glutamate - three neurotransmitters that play key roles in psychotic disorders. It is primarily prescribed for schizophrenia treatment in adults. Unlike other available treatments, it provides an innovative mechanism of action that not only modulates serotonin and dopamine but also improves glutamate function – making it potentially beneficial where others fall short. The side effect profile is relatively benign compared to some older drugs in this class.
Brexpiprazole (the generic name for Rexulti), another atypical antipsychotic medication, acts mainly through partial agonism of serotonin and dopamine receptors. Approved by the FDA in 2015, it's used as both monotherapy for schizophrenia and adjunctive therapy with antidepressants for major depressive disorder. Although effective, its influence on multiple neurotransmitter systems can result in a wider array of potential side effects compared to more selective agents.
What conditions is Caplyta approved to treat?
Caplyta is approved for the treatment of various mental health disorders:
- Schizophrenia in adults
- Bipolar disorder
- Major depressive disorder (as an adjunctive therapy)
Rexulti, on the other hand, has been sanctioned for use in treating:
- Schizophrenia
- Major depressive disorder as an add-on treatment to antidepressants
How does Caplyta help with these illnesses?
Caplyta helps to manage schizophrenia by adjusting the levels of dopamine and serotonin in the brain. It is an atypical antipsychotic, meaning that it works differently than traditional antipsychotics. Rather than completely blocking dopamine receptors, Caplyta partially blocks them while also acting on serotonin receptors. Dopamine and serotonin are neurotransmitters, chemicals that act as messengers in the brain and throughout the body. They play important roles in mood, cognition, memory, reward systems, sleep patterns among other functions. Imbalances of these neurotransmitters are thought to contribute to symptoms seen in conditions like schizophrenia. By fine-tuning their levels and functioning within neural pathways associated with mood and cognition through its dual mechanism of action on both types of receptors - dopaminergic and serotonergic -, Caplyta can help patients manage their condition more effectively.
What is Rexulti?
Rexulti, also known as brexpiprazole, is an atypical antipsychotic that works by balancing the levels of serotonin and dopamine in the brain. Unlike Caplyta (lumateperone), Rexulti does not inhibit serotonin reuptake but instead acts as a partial agonist for both dopamine D2 receptors and serotonin 5-HT1A receptors while acting as an antagonist for serotonin 5-HT2A receptors. This mechanism of action is thought to reduce overactivity in these neurotransmitter systems which can be beneficial for managing symptoms of schizophrenia and major depressive disorder (MDD). Approved by the FDA in 2015, Rexulti's side effect profile differs from typical antipsychotics; it has less likelihood to cause sedation, weight gain or sexual dysfunction - common side effects seen with other medications like Caplyta. Furthermore, it may have additional benefits in patients who do not respond adequately to "typical" antipsychotic drugs.
What conditions is Rexulti approved to treat?
Rexulti is a medication that has been approved by the FDA for use in:
- Major depressive disorder (MDD) as an adjunctive treatment, which means it's used alongside other antidepressants to enhance their effectiveness
- Schizophrenia, where it acts as an antipsychotic to help manage symptoms such as hallucinations and delusions.
How does Rexulti help with these illnesses?
Dopamine is a neurotransmitter that plays essential roles in the brain, affecting motivation, pleasure sensations and motor function. Like serotonin, low levels of dopamine have been associated with depression. Rexulti works by adjusting the balance of dopamine and serotonin available in the brain to improve mood, thought processes and cognition. Its influence on these two important neurotransmitters may play key roles in Rexulti's efficacy as an antipsychotic medication. Since it also moderately affects norepinephrine receptors, it can be prescribed when a patient does not respond well to other atypical antipsychotics (such as Caplyta), or it might be combined with them for more effective symptom management.
How effective are both Caplyta and Rexulti?
Both lumateperone (Caplyta) and brexpiprazole (Rexulti) have been recognized as effective treatments for patients with schizophrenia, and they were initially approved by the FDA within a few years of each other. Since they act on different receptors in the brain, they may be prescribed under varying circumstances. The efficacy of Caplyta and Rexulti in alleviating symptoms of schizophrenia was directly studied in separate clinical trials; both drugs exhibited promising safety profiles and similar effectiveness at managing symptoms.
A 2019 review on lumateperone demonstrated that it is effective from the first week of treatment, its side effect profile is well-tolerated compared to other antipsychotics, and it shows promise even in elderly populations. This study reports that lumateperone has become a useful option for treating patients with schizophrenia due to its unique pharmacology which involves serotonin receptor antagonism along with dopamine receptor modulation.
On the other hand, a 2015 review indicated that Rexulti seems to be more effective than placebo in treating schizophrenia while displaying fewer extrapyramidal side effects - movement disorders often induced by typical antipsychotic drugs. Nonetheless, Rexulti is typically considered as an adjunctive therapy or second-line treatment option when response to initial medication has not been satisfactory. Significant research still involves co-prescribing Rexulti alongside another antipsychotic so data confirming its efficacy as a stand-alone treatment is less robust than that for Caplyta.
At what dose is Caplyta typically prescribed?
Oral dosages of Caplyta for the treatment of schizophrenia in adults are 42 mg/day. Research has suggested that this dosage is effective for most people and does not necessitate a gradual increase from a lower starting dose. Rexulti, on the other hand, starts at an initial daily dose of 0.5 or 1 mg with subsequent increases based on individual patient tolerability and efficacy to a target recommended dosage range between 2mg/day -4mg/day for major depressive disorder as an adjunctive therapy or up to 3-4mg /day when used alone in adults with schizophrenia. In either case, it's important to follow your healthcare provider's instructions carefully as exceeding these recommended dosages may lead to unnecessary risks.
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At what dose is Rexulti typically prescribed?
Rexulti treatment is typically initiated at a dose of 0.5 mg to 1 mg/day, which can then be increased on a weekly basis by increments of 0.5 or 1 mg based on patient response and tolerability. The recommended target dosage range for the treatment of major depressive disorder (MDD) is from 1-2mg daily and for schizophrenia, it's between 2-4mg daily. This dosing should be divided into one single daily dose taken with or without food. It may take several weeks before patients see an improvement in their symptoms; if there is no significant improvement after this period, your physician might consider adjusting the dosage up to the maximum allowed amount of Rexulti, which is generally around 4mg per day.
What are the most common side effects for Caplyta?
Common side effects of Caplyta can include:
- Sleepiness (somnolence)
- Diarrhea
- Dry mouth
- Increased levels of certain enzymes in your blood
- Nausea
- Uncontrolled movements, such as restlessness or tremor
On the other hand, Rexulti may cause side effects like:
- Weight gain
- Movement disorders including tremors, stiffness and slow movement (extrapyramidal symptoms)
- Restlessness (akathisia) -Nervousness -Dry mouth -Sleepiness/drowsiness -Dyspepsia/Indigestion
Always remember to consult with a healthcare professional when experiencing any unusual physical or mental changes after taking medication.
Are there any potential serious side effects for Caplyta?
While taking Caplyta, you should be aware of potential side effects and risks. In rare cases, serious side effects can occur:
- Any thoughts about suicide or self-harm
- Signs of an allergic reaction or severe skin reaction: hives, difficulty breathing, swelling in your face or throat, fever, sore throat, burning eyes, skin pain. A red or purple skin rash with blistering and peeling could also signify a dangerous condition called Stevens-Johnson syndrome.
- Vision problems such as blurred vision; tunnel vision; eye pain or swelling; seeing halos around lights
- Fast or pounding heartbeats; fluttering in your chest; shortness of breath and sudden dizziness (feeling like you might pass out) Low sodium levels in the body - this can lead to headache confusion slurred speech severe weakness vomiting loss of coordination feeling unsteady. Severe nervous system reaction - very stiff (rigid) muscles high fever sweating confusion fast or uneven heartbeats tremors feeling like you might pass out. Metabolic changes including weight gain increased blood sugar levels (hyperglycemia), cholesterol and triglyceride level increases which may increase the risk for diabetes hypertension elevated lipids and certain types cardiovascular disease.
If experiencing any symptoms listed above while on Caplyta therapy it would be crucial to contact healthcare professional immediately.
What are the most common side effects for Rexulti?
Consider Rexulti, a medication similar to Caplyta, but each drug comes with its own set of potential side effects. Some people taking Rexulti might experience:
- Dry mouth or throat discomfort
- Nasal congestion
- Tinnitus (ringing in the ears)
- Visual disturbances
- Gastrointestinal issues such as nausea, vomiting, stomach pain or constipation
- Sleep disturbances including insomnia
- Neurological symptoms like tremors, sweating and feelings of anxiety or nervousness
- An abnormally fast heart rate
- Mental changes like confusion or agitation and even hostility in some cases
-Rashes on the skin
-Unintended weight loss
-Increased frequency of urination
-Generalized headache and dizziness
-Musculoskeletal complaints including muscle stiffness or joint pain.
It's important to remember that not everyone will experience these side effects and they may vary from person to person based on their unique physiology and other medications they might be taking concurrently.
Are there any potential serious side effects for Rexulti?
Rexulti, while generally well-tolerated, can sometimes present serious side effects. If you notice any of the following symptoms while taking Rexulti, it's important to seek medical attention immediately:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling in your face, lips, tongue or throat.
- Uncontrolled movement disorders including tremors and spasms (these may not go away even after stopping Rexulti).
- Increased thoughts about suicide - Report any new or worsening symptoms to your doctor.
- High blood sugar – Symptoms include increased thirst or urination, hunger, dry mouth and fruity breath odor.
- Low white blood cell counts - This might lead to unexpected infections which could be severe. Watch for symptoms like fever, sore throat and other flu-like signs.
- Neuroleptic malignant syndrome (NMS) - Watch out for high fever, stiff muscles, confusion and increased heartbeats.
Remember that this is not a complete list of side effects. Always consult with a healthcare professional if you have concerns about potential adverse reactions during your treatment with Rexulti.
Contraindications for Caplyta and Rexulti?
Both Caplyta and Rexulti, like most other antipsychotic medications, may worsen symptoms of depression in some individuals. If you notice your depression escalating or if thoughts of self-harm or suicide increase while on these medications, please contact a healthcare professional immediately.
Neither Caplyta nor Rexulti should be taken by those who are currently taking or have recently stopped taking monoamine oxidase inhibitors (MAOIs). Your physician must be informed about all the medication you're currently using; MAOIs demand approximately 5 weeks to clear from one's system to prevent hazardous interactions with either Rexulti or Caplyta.
How much do Caplyta and Rexulti cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Caplyta (42 mg) averages around $1,500, which works out to approximately $50/day.
- The price for 30 tablets of Rexulti (2 mg), on average, is about $1,200. This works out to around $40/day.
Thus, if you're considering either drug based on cost alone and are likely to be in the higher dosage range for Caplyta (i.e., 42 mg/day), then brand-name Rexulti could potentially be a less expensive option on a per-day treatment basis. However, remember that cost should not be your primary consideration when deciding which medication is best suited to your needs.
Currently there aren't generic versions available for either Caplyta or Rexulti as they are still under patent protection. Therefore costs remain relatively high compared with medications where generics exist. As always consult with your healthcare provider before making any changes to medication based upon cost alone.
Popularity of Caplyta and Rexulti
Caplyta (lumateperone) and Rexulti (brexpiprazole), both are atypical antipsychotic medications mainly used to treat schizophrenia.
Rexulti was approved by the FDA in 2015 and it has gained significant traction since then due to its efficacy in treating not just schizophrenia but also as an adjunctive treatment for major depressive disorder. In 2020, approximately 1 million prescriptions were filled for Rexulti, making it one of the more commonly prescribed newer-generation antipsychotics.
On the other hand, Caplyta is a relatively new entrant into this class of drugs with FDA approval coming only as recently as late December 2019. As such, comprehensive prescribing data isn't available yet; however, early signals suggest that clinicians have started adopting it into their practices given its novel mechanism of action and promising clinical trial results. The prevalence rate of Caplyta usage is thus still evolving.
Conclusion
Both Caplyta (lumateperone) and Rexulti (brexpiprazole) are prescribed for the treatment of schizophrenia, and have shown efficacy in clinical trials. They can also be used as an add-on therapy for depression, though this decision depends on a physician's discretion as they may interact with other antidepressants. Both drugs work by modulating dopamine and serotonin receptors but their exact mechanisms differ, which is why they might be chosen under different circumstances.
Caplyta is relatively new to the market compared to Rexulti, hence its long-term effects aren't fully known yet unlike those of Rexulti. However, both medications come only in brand-name forms currently, leading to higher costs especially for patients paying out-of-pocket.
The side effect profiles of Caplyta and Rexulti are similar; common ones include restlessness, weight gain and sleepiness. However, some studies suggest that Caplyta may cause less weight gain than other antipsychotics like Rexulti. As is the case with all antipsychotic medications, patients must closely monitor their moods when starting these treatments due to potential worsening symptoms or emergence of suicidal thoughts or self-harm tendencies.