Schizophrenia.com

Reading the panss scores for caplyta?

Does anyone know how to read panss scores? I saw that the placebo was 15.1 and lumateperone (caplyta) was 14.6 so I want a good medicine but I don’t want to relapse for it. Is 14.6 a relapse score I dunno what the scores even used for. But I do know I want another medicine

The main issue with caplyta was that the placebo performed exceptionally well, not that the drug performed badly. @twinklestars probably has more scientific information than that.

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Thank you! Can you tell me where it shows on the scale of antipsychotics how strong the medicine is? I think I might risk the hospital again and take it

On Caplyta (Lumateperone) it outperformed placebo in 2 of 3 late stage trials apparently due to a high placebo response rate. As far as the points reduction on the PANSS it seems to have been pretty consistent throughout the trials.

I don’t know of a scale of how strong antipsychotics are.

This has some information on the response rate:

At 150 days of treatment in 340 patients, 30% had achieved a PANSS response, defined as at least a 20% improvement in PANSS total score, compared with baseline. At 300 days in the smaller group who had reached that milestone at the time of the interim analysis, the PANSS response rate had grown to 41%.

Among patients with schizophrenia and comorbid depression as defined by a Calgary Depression Scale for Schizophrenia (CDSS) score of 6 or more at baseline, lumateperone at 42 mg/day improved depressive symptoms, such that 60% of those patients achieved a CDSS response – that is, at least a 50% reduction in the score – by day 75.

Some other antipsychotics appear to have higher response rates. But there’s no test for who will be a responder and who won’t.

This would probably be best discussed with your doctor. This is a new medication and they haven’t yet had the opportunity to really compare it against others in the long term.

My best guess (I am not a doctor) is it’ll work for some and not others, and for those it does work for, the side effect profile seems promising.

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Thank you professor @twinklestars! I knew I could count on you!

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Thank you guys! But I’m still looking for clues so can you tell me about the one that failed? It’s very important to me that I don’t end up in the hospital again because I scared all my doctors with my symptoms

I’m not sure what you mean by the one that failed? Caplyta (Lumateperone) was approved, so it can’t be said to have failed.

However out of three trials, one had a higher response rate for placebo. When they averaged all three together, Caplyta (Lumateperone) still did better than placebo.

That’s not entirely uncommon for trials to have problems with high placebo response. The FDA takes that into account.

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Starting to get more excited about it now. I don’t understand things like research but I do know I have had rhinitis for 8 years and I’ve been begging my dad and everyone to stop the twisting in my sinus cavities from the medicine. I can’t even smile. No sense of humor anymore and i strongly believe that it’s dopamine blockage causing all my problems because when I get on stimulants whether it’s being poisoned with them or not it makes the cracking in my skull go away. I hear it cracking the bones and it really hurts

I haven’t heard of sinus difficulties being caused by D2 blockade (but I wouldn’t know, ask your doctor.) Lumateperone’s D2 blockade is less than most other antipsychotics, but there still is some.

Is this due to allergies? There’s some interesting research lately on the old antihistamine clemastine possibly improving mylenation and depression caused by social isolation in mouse models, and in humans with hypoxia and with MS.

Edit: clemastine is not an antipsychotic and is not a replacement for antipsychotics.

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It said 30% achieve panss scale, is that mean only 30 % of patients will respond well to it?

I want to know what placebo that they use in the trails.

They’ve used identical “sugar pills” basically just starch that looks the same as the pill, and for the active comparator group, I believe it was risperidone.

The 30%-41% who achieve a PANSS response means they got at least 20% better. That would mean the remaining 59% (after 300 days) did not get at least 20% better.

The thing is, there’s no way to tell if you would be in the 41% or in the 59% or how much you would improve or not. Hopefully someday they will be better able to predict who should have what med.

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Wait so meds would only help just 20%???
I was hoping at least 50-75%

Most meds are like that. That’s why we have such a variety. Different people respond better to different meds.

A 20% improvement is the minimum to be considered effective. Many people do get more improvement than that.

It’s individual though so you could have 0% improvement or 75% improvement, they are averaging together the responses of the people in the study - although the response rate does include only those who got more than 20% better.

One thing about these studies though is they were on people who were already stable on antipsychotics. So if they had already improved on whatever they were already on, and then improved further on Caplyta, that would be pretty good.

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I went back to review the article, because I think it’s important. They were not taking people who were first diagnoses or off meds and wildly psychotic and seeing what the symptom reduction was from there. They were testing it on people who were already pretty stable. So to have a continued reduction over time plus better side effect profile is pretty good.

Part 1 [of the open label switching study] was conducted in 302 patients with stable, generally mild schizophrenia symptoms while on risperidone, olanzapine, or various other antipsychotics commonly prescribed in the United States.

Part 2 was also on

603 patients with stable symptoms on standard-of-care antipsychotics.

So stable and mild and then further improvement of 20% or more for 30-41% seems perfectly respectable. It’s also possible that for some of those they did not see much further improvement in the PANSS score but liked the med anyway because they stayed about the same, but lost weight or had their prolactin go down.

It also seems to be much more effective on co-morbid depression.

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So it just like an add on antipsychotic? How do we know if it will work by itself?

No it’s not an add-on antipsychotic. They switched the people from risperidone, olanzapine etc over to lumateperone and back. But I see how it looks like that from what I posted.

They were only taking one antipsychotic at a time, either the lumateperone or their regular antipsychotic.

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Thank you for replying. They also said it is as effective as 4 mg risperidon. I hope it is strong enough to reduce the hallucinations.

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This lingo called “PANSS”, why dont they add cognitive symptoms to it ?