Lumateperone - Revision history

CategoryClaude: Sentence-case category link per house style (Mood_Stabilizers → Mood_stabilizers)

2026-05-23T05:02:21Z

Sentence-case category link per house style (Mood_Stabilizers → Mood_stabilizers)

← Older revision		Revision as of 05:02, 23 May 2026
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	[[Category:5HT2A Antagonists]]		[[Category:5HT2A Antagonists]]
	[[Category:Psychotic Disorders]]		[[Category:Psychotic Disorders]]
	[[Category:Mood ~~Stabilizers~~]]		[[Category:Mood stabilizers]]

MDElliottMD: Category taxonomy (#23): retag to house-compliant neuroleptic categories

2026-05-22T14:41:26Z

Category taxonomy (#23): retag to house-compliant neuroleptic categories

← Older revision		Revision as of 14:41, 22 May 2026
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	}}		}}

	[[Category:Second-~~Generation Antipsychotics (SGAs / Atypicals)~~]]		[[Category:Second-generation neuroleptics]]
	[[Category:Neuroleptics]]		[[Category:Neuroleptics]]
	[[Category:Atypical Antipsychotics]]		[[Category:Atypical Antipsychotics]]
	~~[[Category:Antipsychotics]]~~
	[[Category:5HT2A Antagonists]]		[[Category:5HT2A Antagonists]]
	[[Category:Psychotic Disorders]]		[[Category:Psychotic Disorders]]
	[[Category:Mood Stabilizers]]		[[Category:Mood Stabilizers]]

MDElliottMD: Dedupe migration per interface-claude 2026-05-20: Antipsychotics / Neuroleptics merged into canonical Neuroleptics. Member retagged.

2026-05-19T18:00:17Z

Dedupe migration per interface-claude 2026-05-20: Antipsychotics / Neuroleptics merged into canonical Neuroleptics. Member retagged.

← Older revision		Revision as of 18:00, 19 May 2026
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	}}		}}

	~~[[Category:Antipsychotics / Neuroleptics]]~~
	[[Category:Second-Generation Antipsychotics (SGAs / Atypicals)]]		[[Category:Second-Generation Antipsychotics (SGAs / Atypicals)]]
	[[Category:Neuroleptics]]		[[Category:Neuroleptics]]

MDElliottMD: Em-dash sweep: replace em-dash with comma per project rule; PendellsCorner verbatim quotes preserved.

2026-05-19T03:16:09Z

Em-dash sweep: replace em-dash with comma per project rule; PendellsCorner verbatim quotes preserved.

← Older revision		Revision as of 03:16, 19 May 2026
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	\| brand = Caplyta		\| brand = Caplyta
	\| classes = Atypical antipsychotic, 5HT2A/D2 antagonist with proposed differential pre/post-synaptic D2 activity		\| classes = Atypical antipsychotic, 5HT2A/D2 antagonist with proposed differential pre/post-synaptic D2 activity
	\| mechanism = Very high affinity 5HT2A receptor antagonism (~50-fold higher affinity than for D2). Moderate D2 receptor activity proposed to be differential between presynaptic (partial agonist) and postsynaptic (antagonist) — if confirmed, this would explain why lumateperone has antipsychotic efficacy at D2 occupancy lower than other antipsychotics. Moderate SERT inhibition (suggests antidepressant potential).		\| mechanism = Very high affinity 5HT2A receptor antagonism (~50-fold higher affinity than for D2). Moderate D2 receptor activity proposed to be differential between presynaptic (partial agonist) and postsynaptic (antagonist), if confirmed, this would explain why lumateperone has antipsychotic efficacy at D2 occupancy lower than other antipsychotics. Moderate SERT inhibition (suggests antidepressant potential).
	\| uses = Schizophrenia (FDA-approved Dec 2019). Bipolar depression as monotherapy or adjunct to lithium/valproate (FDA-approved Dec 2021).		\| uses = Schizophrenia (FDA-approved Dec 2019). Bipolar depression as monotherapy or adjunct to lithium/valproate (FDA-approved Dec 2021).
	\| starting_dose = 42 mg PO once daily with food (no titration)		\| starting_dose = 42 mg PO once daily with food (no titration)
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	\| pregnancy = Limited data; National Pregnancy Registry for Atypical Antipsychotics		\| pregnancy = Limited data; National Pregnancy Registry for Atypical Antipsychotics
	\| legal = Rx		\| legal = Rx
	\| intro = '''Lumateperone''' (brand name Caplyta) is an atypical antipsychotic FDA-approved in 2019 for schizophrenia and in 2021 for bipolar depression. Its receptor profile combines very high 5HT2A antagonist affinity with moderate D2 activity that is hypothesized to be differential between pre- and post-synaptic compartments — proposed mechanism is presynaptic D2 partial agonism (reducing DA release) plus postsynaptic D2 antagonism. If this differential is real, it explains efficacy at lower D2 occupancy and the favorable metabolic/motor side effect profile observed clinically. Stahl emphasizes this mechanism story; primary evidence is still preliminary.		\| intro = '''Lumateperone''' (brand name Caplyta) is an atypical antipsychotic FDA-approved in 2019 for schizophrenia and in 2021 for bipolar depression. Its receptor profile combines very high 5HT2A antagonist affinity with moderate D2 activity that is hypothesized to be differential between pre- and post-synaptic compartments, proposed mechanism is presynaptic D2 partial agonism (reducing DA release) plus postsynaptic D2 antagonism. If this differential is real, it explains efficacy at lower D2 occupancy and the favorable metabolic/motor side effect profile observed clinically. Stahl emphasizes this mechanism story; primary evidence is still preliminary.

	Lumateperone also has moderate SERT inhibition (mood-relevant), explaining its bipolar depression efficacy. Among atypicals, it has notably low rates of weight gain, metabolic syndrome, prolactin elevation, akathisia, and parkinsonism in trials.		Lumateperone also has moderate SERT inhibition (mood-relevant), explaining its bipolar depression efficacy. Among atypicals, it has notably low rates of weight gain, metabolic syndrome, prolactin elevation, akathisia, and parkinsonism in trials.

Maintenance script: Expand Lumateperone with Stahl-sourced detail (with skepticism)

2026-05-16T02:03:44Z

Expand Lumateperone with Stahl-sourced detail (with skepticism)

← Older revision		Revision as of 02:03, 16 May 2026
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	{{MedTemplate		{{MedTemplate
	~~\| generic = Lumateperone~~		\| brand = Caplyta
	\| brand = Caplyta		\| classes = Atypical antipsychotic, 5HT2A/D2 antagonist with proposed differential pre/post-synaptic D2 activity
	~~\| structure =~~		\| mechanism = Very high affinity 5HT2A receptor antagonism (~50-fold higher affinity than for D2). Moderate D2 receptor activity proposed to be differential between presynaptic (partial agonist) and postsynaptic (antagonist) — if confirmed, this would explain why lumateperone has antipsychotic efficacy at D2 occupancy lower than other antipsychotics. Moderate SERT inhibition (suggests antidepressant potential).
	\| classes = ~~Antipsychotic~~, ~~Neuroleptic~~		\| uses = Schizophrenia (FDA-approved Dec 2019). Bipolar depression as monotherapy or adjunct to lithium/valproate (FDA-approved Dec 2021).
	\| mechanism = 5-~~HT2A~~ antagonist~~; D1 potentiator;~~ D2 ~~modulator~~		\| starting_dose = 42 mg PO once daily with food (no titration)
	\| uses =		\| preparations = 42 mg capsules
	\| starting_dose =		\| fda_max = 42 mg/d
	\| preparations =		\| routes = Oral
	\| fda_max =		\| onset = Antipsychotic effect over weeks
	\| routes =		\| duration = Daily dosing
	\| onset =		\| halflife = ~18 hours (terminal)
	\| duration =		\| bioavailability = Limited but adequate; take with food
	\| halflife =		\| pregnancy = Limited data; National Pregnancy Registry for Atypical Antipsychotics
	\| bioavailability =		\| legal = Rx
	\| pregnancy =		\| intro = '''Lumateperone''' (brand name Caplyta) is an atypical antipsychotic FDA-approved in 2019 for schizophrenia and in 2021 for bipolar depression. Its receptor profile combines very high 5HT2A antagonist affinity with moderate D2 activity that is hypothesized to be differential between pre- and post-synaptic compartments — proposed mechanism is presynaptic D2 partial agonism (reducing DA release) plus postsynaptic D2 antagonism. If this differential is real, it explains efficacy at lower D2 occupancy and the favorable metabolic/motor side effect profile observed clinically. Stahl emphasizes this mechanism story; primary evidence is still preliminary.
	\| legal =
	\| intro =		Lumateperone also has moderate SERT inhibition (mood-relevant), explaining its bipolar depression efficacy. Among atypicals, it has notably low rates of weight gain, metabolic syndrome, prolactin elevation, akathisia, and parkinsonism in trials.
	~~\| pharmacokinetics =~~		\| pharmacodynamics= 5HT2A antagonism Ki ~0.5 nM; D2 antagonism Ki ~32 nM; D1 antagonism Ki ~52 nM; α1A antagonism Ki ~73 nM; SERT inhibition Ki ~33 nM. Minimal H1, M, α2 binding (explains low sedation, no anticholinergic burden, no weight gain).
	\| pharmacodynamics =		\| effects = Most common: somnolence/sedation, dry mouth, fatigue, nausea. Low rates of: metabolic effects, weight gain, prolactin elevation, akathisia, parkinsonism, tardive dyskinesia. Class warning: increased mortality in elderly dementia-related psychosis.
	\| ~~indications~~ =		\| interactions = <pharmaInteractions/>
	~~\| dosing =~~
	\| effects =
	\| interactions = <pharmaInteractions/>
	~~\| pregnancy_details =~~
	~~\| monitoring =~~
	~~\| counseling =~~
	~~\| anecdotes =~~
	~~\| seealso =~~
	~~\| references =~~
	}}		}}


	[[Category:Antipsychotics / Neuroleptics]]		[[Category:Antipsychotics / Neuroleptics]]
	[[Category:Second-Generation Antipsychotics (SGAs / Atypicals)]]		[[Category:Second-Generation Antipsychotics (SGAs / Atypicals)]]
	[[Category:Neuroleptics]]		[[Category:Neuroleptics]]
			[[Category:Atypical Antipsychotics]]
			[[Category:Antipsychotics]]
			[[Category:5HT2A Antagonists]]
			[[Category:Psychotic Disorders]]
			[[Category:Mood Stabilizers]]

MediaWiki default: Assign pharmacological categories from List_of_CNS-active_medicines

2026-05-14T15:06:51Z

Assign pharmacological categories from List_of_CNS-active_medicines

← Older revision		Revision as of 15:06, 14 May 2026
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	}}		}}


			[[Category:Antipsychotics / Neuroleptics]]
			[[Category:Second-Generation Antipsychotics (SGAs / Atypicals)]]
	[[Category:Neuroleptics]]		[[Category:Neuroleptics]]

MDElliottMD: Pharmacopedia: add

2026-05-14T03:30:57Z

Pharmacopedia: add <pharmaInteractions/>

← Older revision		Revision as of 03:30, 14 May 2026
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	\| dosing =		\| dosing =
	\| effects =		\| effects =
	\| interactions =		\| interactions = <pharmaInteractions/>
	\| pregnancy_details =		\| pregnancy_details =
	\| monitoring =		\| monitoring =

MDElliottMD: Pharmacopedia: remove contraindications parameter

2026-05-14T02:40:39Z

Pharmacopedia: remove contraindications parameter

← Older revision		Revision as of 02:40, 14 May 2026
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	\| dosing =		\| dosing =
	\| effects =		\| effects =
	~~\| contraindications =~~
	\| interactions =		\| interactions =
	\| pregnancy_details =		\| pregnancy_details =

MDElliottMD: Added empty fda_max parameter to MedTemplate call

2026-05-13T02:32:40Z

Added empty fda_max parameter to MedTemplate call

← Older revision		Revision as of 02:32, 13 May 2026
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	\| starting_dose =		\| starting_dose =
	\| preparations =		\| preparations =
			\| fda_max =
	\| routes =		\| routes =
	\| onset =		\| onset =
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	[[Category:Neuroleptics]]		[[Category:Neuroleptics]]

MDElliottMD: Expand stub to full MedTemplate parameter set

2026-05-13T01:00:00Z

Expand stub to full MedTemplate parameter set

@@ Line 1: / Line 1: @@
 {{MedTemplate
-| generic           = Lumateperone
+| generic            = Lumateperone
-| brand             = Caplyta
+| brand              = Caplyta
-| classes           = Antipsychotic, Neuroleptic
+| structure          =
-| mechanism         = 5-HT2A antagonist; D1 potentiator; D2 modulator
+| classes            = Antipsychotic, Neuroleptic
 }}
 [[Category:Neuroleptics]]