| Major Depressive Disorder
Caplyta vs Spravato
Side-by-side clinical, coverage, and cost comparison for major depressive disorder.Deep comparison between: Caplyta vs Spravato with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsSpravato has a higher rate of injection site reactions vs Caplyta based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Spravato but not Caplyta, including UnitedHealthcare
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Category
Caplyta
Spravato
At A Glance
Oral
Once daily
Atypical antipsychotic
Intranasal
Twice weekly to every 2 weeks
NMDA receptor antagonist
Indications
- Schizophrenia
- Depression, Bipolar
- Major Depressive Disorder
- Depressive Disorder, Treatment-Resistant
- Major Depressive Disorder
Dosing
Schizophrenia, Depression, Bipolar, Major Depressive Disorder 42 mg orally once daily with or without food; no dose titration needed.
With strong CYP3A4 inhibitors Reduce to 10.5 mg once daily.
With moderate CYP3A4 inhibitors Reduce to 21 mg once daily.
Moderate or severe hepatic impairment Reduce to 21 mg once daily (Child-Pugh class B or C).
Depressive Disorder, Treatment-Resistant Induction (Weeks 1-4): 56 mg or 84 mg intranasally twice weekly; Maintenance (Weeks 5-8): 56 mg or 84 mg once weekly; Week 9 and after: 56 mg or 84 mg every 2 weeks or once weekly, individualized to the least frequent dosing to maintain remission/response.
Major Depressive Disorder 84 mg intranasally twice weekly for 4 weeks in conjunction with an oral antidepressant; dose may be reduced to 56 mg twice weekly based on tolerability.
Contraindications
- History of hypersensitivity reaction to lumateperone or any component of CAPLYTA (including pruritus, rash, and urticaria)
- Aneurysmal vascular disease (including thoracic and abdominal aorta, intracranial, and peripheral arterial vessels) or arteriovenous malformation
- History of intracerebral hemorrhage
- Hypersensitivity to esketamine, ketamine, or any excipient
Adverse Reactions
Most common (>=5%) Somnolence/sedation, dizziness, nausea, dry mouth, headache, fatigue, diarrhea, vomiting
Serious Neuroleptic malignant syndrome, tardive dyskinesia, metabolic changes, leukopenia/neutropenia/agranulocytosis, orthostatic hypotension and syncope, seizures, suicidal thoughts and behaviors, cerebrovascular adverse reactions including stroke in elderly patients with dementia-related psychosis
Postmarketing Burning sensation, including skin burning sensation
Most common (>=5%) dissociation, dizziness, nausea, sedation, vertigo, hypoesthesia, anxiety, lethargy, blood pressure increased, vomiting, feeling drunk
Serious sedation, dissociation, respiratory depression, blood pressure increase, cognitive impairment, impaired ability to drive and operate machinery, ulcerative or interstitial cystitis, embryo-fetal toxicity
Postmarketing bradycardia, respiratory depression (including respiratory arrest), hypotension
Pharmacology
Lumateperone is an atypical antipsychotic whose mechanism may be mediated through antagonist activity at central serotonin 5-HT2A receptors and partial agonist activity at central dopamine D2 receptors; it also has moderate SERT inhibitory activity and moderate binding affinity for dopamine D1, D4, and adrenergic alpha-1 receptors.
Esketamine is the S-enantiomer of racemic ketamine and a non-selective, non-competitive NMDA receptor antagonist; the mechanism by which it exerts its antidepressant effect is unknown.
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Most Common Insurance
Anthem BCBS
Caplyta
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (5/12) · Qty limit (2/12)
Spravato
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (0/12)
UnitedHealthcare
Caplyta
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (4/8) · Qty limit (6/8)
Spravato
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (6/8) · Qty limit (3/8)
Humana
Caplyta
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Spravato
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (1/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableHealthWell: Schizophrenia - Medicare Access
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
$10/fillfill
Spravato with Me Savings ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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CaplytaView full Caplyta profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.