MDD Exacerbation

M.E. is a 54-year-old male established patient of 6.5 years presenting to discuss changing his antidepressant after more than 6 years of strong remission, as he now feels he is “spiraling.” After researching online, he specifically asks about switching to lumateperone (Caplyta®).

He initially presented 6.5 years ago for medication management after severe, longstanding depression dating back to adolescence, with poor prior medication experiences and an unsuccessful trial of TMS. At that time he described chronic low mood and inability to feel happy, anhedonia, irritability, low energy/malaise, poor sleep (sleep onset and maintenance issues), and variable appetite, which significantly affected his work and relationships despite otherwise stable life circumstances. He has ongoing family and social supports, including a stable job, two children he co-parents with his ex-wife, and a long-term fiancé.