Caplyta occupies the dubious honor of being the 13th second generation antipsychotic granted FDA approval. Other members of the family include Zyprexa, Abilify, Risperdal and Rexulti. Unlike some of the others, Caplyta is only marketed to treat symptoms of schizophrenia. Caplyta is an oral drug administered once daily with meals. The dose is 42 mg.

Schizophrenia includes positive and negative symptoms. The positive symptoms of delusions and hallucinations may improve with Caplyta but the drug appears less likely to help the negative symptoms of apathy, social withdrawal and blunted affect.

Short term trials involving relatively few patients demonstrate relatively unremarkable improvement. Caplyta does not appear to offer any distinct or unique advantages compared to the other 2nd generation antipsychotics. For the cash price of nearly $1600 a month one would expect special benefits. The cash price of other popular generic antipsychotics may be as low as $10 a month.

Caplyta may interact with a variety of other medicines. A special black box warning cautions against use in elderly patients with dementia. Sedation and somnolence occur in up to 1 in 4 patients. Difficulty swallowing due to esophageal problems may lead to aspiration. Dystonia presents as spasm of the neck muscles, tightness of the throat and difficulty breathing.

Unusual movements of the mouth, lips, tongue and eyelids known as tardive dyskinesia may or may not resolve with discontinuation of therapy. Metabolic changes include increase in blood sugar, weight gain and elevation of serum lipids. The white blood count may decrease and potentially serious declines in blood pressure on standing also known as orthostatic hypotension expose the patient to potential falls and fractures. Seizures may occur.