Emerging Therapies in Bipolar Disorder Treatment

In this video, Rakesh Jain, MD, MPH, psychiatrist at Mental Wellness in Austin, Texas, discusses the recent advances and emerging therapies coming out in bipolar disorder treatment. While highlighting innovative therapies like the olanzapine-samidorphin combination, cariprazine, and lumateperone, Dr Jain also emphasizes the enduring value of traditional treatments such as lithium. Learn about the safety and efficacy of these new agents and gain insights into improving diagnosis and treatment strategies. 

Catch up on part 2 of this interview with Dr Jain here: Navigating Cardiometabolic Symptoms With Conventional Bipolar Disorder Therapies.

Read the Transcript: 

Psych Congress Network: What recent advances or emerging therapies in bipolar disorder treatment are you particularly excited about? What are the safety and efficacy profiles of those newer agents compared to traditional treatments?

Rakesh Jain, MD: We have a lot of new treatments, but just to make sure you and I don't forget about some of the excellent older treatments that we underutilize, lithium is probably one of the most underutilized medications in all of psychiatry. So I just wanted to put that bug in your mind to at least think about opportunities to use the oldest medication we have in the world of bipolar disorder. At the same time we do have some significant advances.

For example, olanzapine plus samidorphin combination, which is Lybalvi, can be very helpful in bipolar mania and bipolar mixed features, especially when your goal is not just to treat the disorder but to also prevent a relapse or a recurrence, [it's a] very effective medication.

The other great advance recently has been cariprazine. Cariprazine has indications in bipolar mania, mixed, depression, unipolar major depression, so it's a pretty broad spectrum. That's a big advance, I think.

Then, of course, we have lumateperone, Caplyta, which has approval for depression in bipolar disorder. Its metabolic profile is quite impressive, both in the short run and in the long run, perhaps because it doesn't have H1 or M1 antagonism of any significant magnitude. That could be one of the reasons.

Having said all of that, the advances are great, but the best advance still is, or the best advice I can offer you is, we are still not doing as well as we should in terms of diagnosis. Let's get better at it. Let's offer psychosocial interventions and monitor for metabolics as closely as we can. But choosing the right medication on day one is by far the best way to go forward. 

Rakesh Jain, MD, MPH, attended medical school at the University of Calcutta in India. He then attended graduate school at the University of Texas School of Public Health in Houston, where he was awarded a “National Institute/Center for Disease Control Competitive Traineeship”. He graduated from the School of Public Health in 1987 with a Masters of Public Health (MPH) degree. Dr Jain served a 3-year residency in Psychiatry at the Department of Psychiatry and Behavioral Sciences at the University of Texas Medical School at Houston. In addition, Dr Jain completed a postdoctoral fellowship in Research Psychiatry at the University of Texas Mental Sciences Institute, in Houston. He was awarded the “National Research Service Award” for the support of this postdoctoral fellowship.