Learning of a Unique Bipolar Depression Medication

I checked my Twitter feed this morning and learned of a new unique bipolar depression medication. I'm going to be honest; it made me smile and set me up for a great day. This is not necessarily because I want to run out and take it, but more because I'm glad people with bipolar disorder suffering from depression finally have a new option that is different than the ones we have been working with for years. A unique bipolar depression medication almost feels like a safety blanket to me.

Why Aren't There More Unique Bipolar Depression Medications?

The issue is that there aren't a lot of unique bipolar depression medications. There are a lot of what we call "me too" drugs. "Me too" drugs are drugs that work the same way as existing drugs. They may be more or less effective for any given person, but they don't fundamentally change the game. They don't form a new class of medications or even work in a new way in the same class.

According to the Food and Drug Administration (FDA), the following are the medications that are approved to treat bipolar depression:¹

• Quetiapine (Seroquel)
• Cariprazine (Vraylar)
• Olanzapine/Fluoextine combination (Symbyax)
• Lurasidone (Latuda)

That's it. After decades of treating bipolar disorder with medication, only those four medications are FDA approved to treat bipolar depression. (Your doctor may choose to treat your bipolar depression with other medications using his or her clinical experience.)

All of these drugs primarily work with the neurotransmitters (chemical messengers in the brain) serotonin and dopamine, although how they affect those neurotransmitters differs. And when you take a look at psychiatric medication used for bipolar disorder as a whole, this is what we do -- we play with dopamine and serotonin in the brain.

And drug companies often look to almost replicate what works. They can't replicate it, of course, that would be the same drug, but they can copy what it basically does, and do it slightly differently. This makes for a more assured financial payoff. If they choose to pursue a truly unique bipolar depression medication, there are more chances they will fail as opposed to going with something they have greater assurance will work.

So why don't we have more unique bipolar depression medications? Because of money, of course.

A Unique Bipolar Depression Medication

As I said, though, I woke up this morning and found that a unique bipolar depression medication announcement² had found its way onto my Twitter feed. This new unique bipolar depression medication actually works on serotonin, dopamine and glutamate.³ It's the "and glutamate" here that's exciting. It means that if you've failed all the ones that only work on serotonin and dopamine, you now have a new option to help you. (I won't go into a whole glutamate screed here, but suffice it to say that I've been saying for years that glutamate looks like a promising area of study in bipolar depression.) 

Now, please understand, this is not a drug endorsement. I'm not saying you should try this medication. That is a decision that only you and your doctor can make. What I'm saying is that for me, who has tried every medication under the sun, this is a very promising thing. I feel hopeful this morning, and I hope this piece has brought you a little of that smile too. 

Sources

1. Soreff, S., "Bipolar Disorder Treatment and Management." Medscape, May 30, 2019.
2. Intra-Cellular Therapies, "Intra-Cellular Therapies Announces FDA Acceptance of CAPLYTA® (lumateperone) sNDAs for the Treatment of Bipolar Depression." May 3, 2021.
3. Correll, C., et al., "Efficacy and Safety of Lumateperone for Treatment of Schizophrenia." Journal of the American Medical Association, Psychiatry, Jan. 8, 2020.