ABSTRACT
Individuals experiencing Lewy body disease (LBD) are particularly vulnerable to the adverse effects of neuroleptics. This sensitivity has been employed by some authorities as a diagnostic component for this disorder. At present, we do not have any Food and Drug Administration-approved antipsychotic for the management of psychotic symptoms in this condition. We present the first case of an LBD patient, showing favorable response in psychotic symptoms with lumateperone, a novel atypical neuroleptic. Our report revealed improvements in cognition, psychosis, and sleep following the initiation of lumateperone without concurrent emergence of extrapyramidal side effects, autonomic instability, parkinsonian features, or cognitive decline, which are typically seen when treated with available antipsychotic medications. Clinicians may wish to consider potential usefulness of lumateperone when managing patients with this disabling condition. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Subject(s)
Antipsychotic Agents , Lewy Body Disease , Psychotic Disorders , United States , Humans , Antipsychotic Agents/adverse effects , Lewy Body Disease/complications , Lewy Body Disease/drug therapy , Lewy Body Disease/chemically induced , Psychotic Disorders/drug therapy , Psychotic Disorders/etiology , Heterocyclic Compounds, 4 or More Rings/therapeutic useABSTRACT
BACKGROUND: Antipsychotic-induced weight gain (AIWG) is a clinically relevant and concerning adverse effect of contemporary antipsychotic medications. Lumateperone is a novel antipsychotic, which became commercially available in 2020 and received Food and Drug Administration approval for schizophrenia and bipolar disorder in 2019 and 2021, respectively. To date, no comprehensive review exists on its AIWG profile. This systematic review aims to assess the association between lumateperone and AIWG. METHODS: Data Sources: A comprehensive search of published studies on "lumateperone" OR "ITI-007" OR "Caplyta" was conducted on PubMed, CINAHL Complete, APA PsychInfo, Cochrane Library, and Embase databases until January 2022.Study Selection: A total of 149 articles in English were collected. After removing duplicates, all human trials on lumateperone were screened for the inclusion criteria.Data Extraction: Two reviewers conducted an independent screening followed by full-text analysis of extracted studies adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Third reviewer resolved the conflicts as tiebreaker. RESULTS: Primary search generated 77 articles, excluding 72 duplicates, of which 51 were deemed appropriate for exclusion. Full-text analysis of the remaining 26 articles concluded with 5 studies for finalized review per inclusion criteria. Excluded studies were manually reviewed for relevant citation of studies per inclusion criteria. Three randomized, double-blinded, placebo-controlled clinical trials and 2 open-label trials were derived from this systematic review. Lumateperone showed a favorable weight profile compared with placebo and alternate antipsychotics. CONCLUSIONS: Lumateperone displays minimal to no weight gain among participants in the studies reviewed.
Subject(s)
Antipsychotic Agents , Bipolar Disorder , Schizophrenia , Antipsychotic Agents/adverse effects , Bipolar Disorder/chemically induced , Bipolar Disorder/drug therapy , Humans , Schizophrenia/drug therapy , Weight GainABSTRACT
The selegiline transdermal system (STS) is the first antidepressant transdermal medication approved by the US FDA for the treatment of major depressive disorder. Its unique antidepressant delivery system allows for steady release of selegiline over 24 h with minimal fluctuation in drug serum levels. It is able to deliver high enough central nervous system concentrations required for an antidepressant effect without substantially inhibiting Monoamine oxidase-A in the gastrointestinal and hepatic system, thereby reducing the risk of tyramine hypertensive crises especially at the lowest doses. Patient adherence theoretically could be improved due to ease of use and once-daily dosing when compared to oral counterparts' need for multiple daily doses. Clinical trials have established that doses between 6 and 12 mg over 24 h have been effective for major depressive disorder and tolerated among patients. Episodes of hypertensive crisis with STS have been minimally reported thus far. Overall, STS appears to be an effective agent for major depressive disorder when held to regulatory standards and post marketing analyses. This paper reviews the pharmacologic characteristics of STS and results of studies investigating its clinical efficacy and safety.