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Lumateperone 42mg plus ADT reduces MADRS score by 22.9 in treatment-resistant MDDTrial shows lumateperone helps adults with major depressive disorder

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Key Takeaway
Note that lumateperone 42mg plus ADT is a tolerated option for patients with inadequate response to 1-2 ADTs.

This Phase 3 open-label extension study evaluated the safety and efficacy of lumateperone 42mg plus antidepressant therapy (ADT) in 809 adults with DSM-5-defined MDD who had an inadequate response to 1-2 ADTs. Patients were required to have a MADRS Total score of at least 24 and a CGI-S score of at least 4.

Over a 26-week follow-up period, patients receiving lumateperone 42mg plus ADT showed significant improvements in secondary outcomes. The MADRS Total score decreased by 22.9 (P<.0001), and the CGI-S score decreased by 2.7 (P<.0001).

Safety data indicated that 67.7% of patients experienced at least one treatment-emergent adverse event (TEAE). The most common events were headache (16.6%), dizziness (10.6%), and dry mouth (8.0%). Notably, 98.9% of TEAEs were mild-to-moderate in severity. EPS-related TEAEs occurred in 3.8% of patients, with no significant changes in body morphology or cardiometabolic parameters. No suicidal behavior emerged during the study.

A primary limitation of this study is the open-label design, which may affect the ability to generalize results to a controlled setting. However, the data suggest lumateperone 42mg plus ADT is a tolerable option for patients with inadequate response to standard therapies.

How this fits prior evidence

How this fits prior evidence: This finding extends the clinical profile of lumateperone in the treatment of major depressive disorder. Specifically, it builds upon the evidence that lumateperone adjunct therapy improves sexual functioning in patients with major depressive disorder. While other options like DORAs have limited evidence for active MDD, this study provides data on lumateperone's safety and efficacy in a population with inadequate response to 1-2 ADTs.

This study looked at how lumateperone works for adults with major depressive disorder who did not get enough relief from one or two standard antidepressants. The study included 809 adults who were taking 42mg of lumateperone daily along with their usual antidepressant treatment over a period of 26 weeks.

Researchers found that patients saw a significant improvement in their symptoms. These improvements were measured using two different scales to track depression levels. The results suggest that the combination of lumateperone and standard therapy can be effective for those who have not found success with standard treatments alone.

Most patients tolerated the medication well, and 84.5% of participants finished the full 26-week treatment. Common side effects included headache, dizziness, and dry mouth. While the study is an open-label design, which means the researchers knew which patients were receiving the treatment, the results show the medication was generally well-tolerated. You should talk to your doctor to see if this treatment is right for your specific needs.

What this means for you:
Lumateperone added to standard antidepressants showed significant improvement in symptoms for some adults with depression.

Common questions

Is lumateperone safe for people with depression?

The study found that lumateperone was generally well-tolerated by the 809 participants. Most side effects were mild to moderate. Common issues included headache (16.6%), dizziness (10.6%), and dry mouth (8.0%). No new suicidal behaviors were reported during the 26-week study period.

Who specifically can benefit from this treatment?

This study focused on adults between the ages of 18 and 65. Specifically, it looked at patients with major depressive disorder who did not have an adequate response to one or two standard antidepressant treatments.

How long did the study last and what were the results?

The study lasted 26 weeks. Patients taking 42mg of lumateperone along with their usual antidepressants showed significant improvements in their depression scores. These improvements were measured using both the MADRS and CGI-S scales.

Study Details

Study typeRct
Sample sizen = 809
EvidenceLevel 2
Follow-up1.4 mo
PublishedJul 2026
View Original Abstract ↓
This Phase 3 open-label extension study (NCT05061719) investigated long-term safety of lumateperone 42mg (simultaneous modulator of serotonin, dopamine, and glutamate neurotransmission) adjunctive to antidepressant therapy (ADT) in patients with major depressive disorder (MDD) with inadequate ADT response. Eligible adults (18-65years) completed 6-week double-blind treatment (NCT04985942; NCT05061706) and had DSM-5-defined MDD with inadequate response to 1-2 ADTs in the current depressive episode, Montgomery-Åsberg Depression Rating Scale (MADRS) Total score ≥24, and Clinical Global Impression-Severity (CGI-S) score ≥4 at lead-in study entry. Patients received 26-week, open-label, oral lumateperone 42mg+ADT once-daily. The primary endpoint was safety/tolerability, assessed by adverse events (AEs), vital signs, and laboratory parameters. The secondary endpoint was efficacy, assessed by MADRS Total score and CGI-S score changes from double-blind baseline to open-label Week 26. Of 809 patients treated, 84.5% completed open-label treatment; 67.7% experienced ≥1 treatment-emergent AE (TEAE). Most common TEAEs (≥5%) were headache (16.6%), dizziness (10.6%), dry mouth (8.0%), nausea (7.7%), somnolence (7.2%), diarrhea (6.2%), and nasopharyngitis (5.2%). The majority (98.9%) of TEAEs were mild-to-moderate severity. Rate of extrapyramidal symptom (EPS)-related TEAEs per broad standardized MedDRA query was low (3.8%). No notable changes in EPS scales, body morphology, or cardiometabolic parameters occurred from double-blind baseline to end of open-label treatment. No emergence of suicidal behavior occurred during treatment. Symptoms of depression improved with lumateperone+ADT from double-blind baseline to open-label Week 26 (mean change: MADRS Total score=-22.9, P<.0001; CGI-S score=-2.7, P<.0001). Overall, lumateperone 42mg+ADT was safe and effective during 26-week treatment in patients with MDD with inadequate ADT response.
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