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Re: How does Lumateperone compare to antidepressants?

Posted by linkadge on June 23, 2020, at 18:07:32

In reply to How does Lumateperone compare to antidepressants?, posted by revv33 on June 23, 2020, at 5:59:37

Lumateperone is a very strong antagonist of 5-ht2a and much less potent as an antagonist at dopamine receptors. As an antipsychotic, it may have fewer dopamine related side effects (i.e. apathy), and as a 5-ht2a antagonist it would be expected to improve sleep, anxiety and perhaps anhedonia (to some degree). Using it alone in unipolar depression, it may behave only weakly as an antidepressant (but it likely depends on the person). It shares the 5-ht2a antagonist effects of drugs like mirtazapine, amitriptyline, and trazodone. If sleep / anxiety were prominent, then it might be more beneficial.

Where it could be particularly useful is either a) as an adjunct to other antidepressants or b) in bipolar depression. Bipolar depression tends to respond differently to antidepressants and oftentimes antipsychotics are better at addressing depression than regular antidepressants. It is not an SSRI (it doesn't increase serotonin by blocking the reuptake mechanism). You could get some sexual dysfunction (owing to the dopamine blockade) but I would think it would be much less likely than with an SSRI. On its own you won't get serotonin syndrome. If it is combined with an SSRI, there is a very very low possibility of some degree of serotonin syndrome. Because the mechanism is quite different to antidepressants, it is not really possible to compare them directly.





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