Lumateperone (Caplyta) is considered one of the newest and most innovative atypical antipsychotics for treating bipolar disorder, receiving FDA approval for bipolar I or II depressive episodes in 2021. It offers a unique mechanism with lower dopamine receptor occupancy and is often used as monotherapy or adjunctive therapy for bipolar depression.
CAPLYTA is proven to deliver significant symptom relief in adults with bipolar I or bipolar II depression. CAPLYTA can be taken alone or with lithium or valproate. Based on total prescriptions dispensed across approved indications since CAPLYTA was FDA‑approved in 2019. MDD indication was approved in November 2025.
Abilify has an average rating of 6.1 out of 10 from a total of 1205 ratings on Drugs.com. 49% of reviewers reported a positive effect, while 34% reported a negative effect. Caplyta has an average rating of 6.7 out of 10 from a total of 200 ratings on Drugs.com.
If you're going to use an antipsychotic in bipolar mania, quetiapine (Seroquel) is first-line. Cariprazine (Vraylar) comes next. Both of those cover the manic and depressive poles.
The drug, from Bristol Meyers Squibb, is called Cobenfy™ (previously known as KarXT), and it was approved by the Food and Drug Administration (FDA) in September 2024. Cobenfy uses a different mechanism of action than previous drugs for schizophrenia.
Clozapine is usually used for people diagnosed with schizophrenia who have had an inadequate response to other antipsychotics or who have been unable to tolerate other drugs due to extrapyramidal side effects.
Common side effects of risperidone include sleepiness, movement problems, and weight gain, whereas brexpiprazole (Rexulti) may cause restlessness, dizziness, and headaches. Additionally, brexpiprazole (Rexulti) is less likely to cause weight gain, high cholesterol, or high blood sugar compared to risperidone.
4.1. Lithium is considered the medicine of choice in the long-term maintenance phase of bipolar disorder.
Vraylar works in a similar way but has a stronger effect on D3 receptors than Abilify. Since D3 receptors are linked to mood, motivation, and cognitive function, this difference may explain why some people respond better to Vraylar.
CAPLYTA® 42 mg is an oral, once daily atypical antipsychotic approved in adults as an adjunctive therapy with antidepressants for major depressive disorder (MDD), schizophrenia, and depressive episodes associated with bipolar I or II disorder (bipolar depression), as monotherapy, and as adjunctive therapy with lithium ...
Both medications can cause serious side effects like neuroleptic malignant syndrome and tardive dyskinesia. Caplyta is less likely to cause weight gain compared to many other antipsychotics, but Vraylar is known for leading to minimal weight gain.
Results: Adherent (n=39) and previously non-adherent patients (n=33) showed a high level of concordance in their rank ordering of reasons for considering stopping taking lithium (Kendall's W=0.059; P=0.001), with 'bothered by the idea that moods were controlled by medication', 'bothered by the idea of a chronic illness ...
Clozapine, which has the strongest antipsychotic effect, can cause neutropenia.
On November 6, 2025, the FDA cleared lumateperone (CAPLYTA®) for use alongside an antidepressant in adults with MDD. This expands its indication to a fourth therapeutic area, joining its prior approvals for schizophrenia and depressive episodes in bipolar I and II disorders.
Lithium is one of the most widely prescribed and studied medications for treating bipolar disorder. Lithium is a natural salt and will reduce symptoms of mania within two weeks of starting therapy, but it may take weeks to months before the manic symptoms are fully managed.
Riskiest Drugs for Someone With Bipolar Disorder
While the exact way VRAYLAR works is unknown, healthcare providers and scientists believe that VRAYLAR helps regulate dopamine and serotonin in the brain. Watch the video to learn more about how VRAYLAR is thought to work.
Vraylar is less likely to cause weight gain compared to other antipsychotics, but it has a higher risk of causing uncontrolled muscle movements. On the other hand, Rexulti is less likely to cause movement side effects but can lead to moderate weight gain.
In 2016, the Food and Drug Administration released a warning regarding the risk of new impulse control problems with aripiprazole, including urges to gamble, binge eat, shop, and engage in sexual intercourse. These problems are rare but may cause significant harm if not recognized in time.
Lithium has been the gold standard for the treatment of bipolar disorder for seven decades due to its efficacy in preventing mood episodes and reducing risk of dying by suicide.
Lithium has an average rating of 7.3 out of 10 from a total of 503 ratings on Drugs.com. 66% of reviewers reported a positive effect, while 20% reported a negative effect. Vraylar has an average rating of 6.1 out of 10 from a total of 572 ratings on Drugs.com.
Conditions such as borderline personality disorder, major depressive disorder, ADHD, and schizoaffective disorder may mimic aspects of bipolar disorder, including mood swings, impulsivity, or episodes of depression and mania-like behavior.
The claim alleges that Otsuka and Lundbeck – the pharmaceutical companies responsible for developing and marketing Rexulti – failed to provide Canadian uses with adequate and timely warnings about the increased risk of impulse control disorders and compulsive behaviours, such as compulsive gambling, compulsive shopping ...
Unlike Seroquel (quetiapine), which has a higher incidence of sedation due to its antagonistic effect on histamine H1 receptor as well as potential metabolic side effects such as weight gain or increased blood sugar levels; Rexulti demonstrates a more favorable side effect profile with less sedation reported commonly.