Novel antipsychotic drugs for the treatment of patients with bipolar depression

Objectives.
This paper aims to examine the role of novel antipsychotics, specifically lurasidone, cariprazine, lumateperone, and brexpiprazole, in the treatment of patients with bipolar depression. Given the limited efficacy of current treatment options and the associated risk of adverse effects, these new pharmaceuticals warrant a thorough evaluation of their clinical utility

Literature review.
The current evidence base indicates the notable efficacy of lurasidone, cariprazine, lumateperone, and brexpiprazole in treating bipolar depression. Lurasidone, whether used as monotherapy or in combination with lithium or valproate, has been shown to alleviate depressive symptoms effectively and has minimal potential for causing metabolic complications. Cariprazine is also an effective treatment option for bipolar I disorder, with a low risk of phase switching from depression to mania. Lumateperone, a recently approved drug with a unique mechanism of action, effectively treats depressive symptoms in patients with bipolar I and II disorders with minimal adverse effects, such as weight gain, motor disturbances, or metabolic issues. Brexpiprazole, pharmacologically similar to aripiprazole, may benefit patients with treatment-resistant depression

Conclusions.
Lurasidone, cariprazine, lumateperone, and brexpiprazole play an important role in modern therapeutic strategies for addressing bipolar depression. Their established efficacy and favourable safety profiles may improve patients’ long-term prognosis and quality of life. Ongoing research on these antipsychotics is necessary to better understand their potential effectiveness and associated risks, particularly in specific clinical populations.