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Impact of Lumateperone compared to Quetiapine on MADRS in Indian patients with Bipolar II depression: A post-hoc analysis of a Phase 3 study

Published online by Cambridge University Press:  26 August 2025

A. Dharmadhikari
Affiliation:
Shree Ashirwad Hospital, Dombivali
P. K. Chaurasia
Affiliation:
Gangoshri Hospital, Varanasi
Y. Patel
Affiliation:
VS General Hospital, Ahmedabad
D. Choudhary
Affiliation:
GSVM Medical College, Kanpur
P. L. Dasud
Affiliation:
Global 5 Hospital, Navi Mumbai
M. Bhirud
Affiliation:
Dhadiwal Hospital, Nashik
P. S. Meena
Affiliation:
Jawahar Lal Nehru Medical College, Ajmer
F. Shah
Affiliation:
Health 1 Super Speciality Hospital, Ahmedabad
G. Ganesan
Affiliation:
Medstar Speciality Hospital, Bangalore
B. P. S. Rathour
Affiliation:
Atmaram Child Care and Critical Care Hospital, Kanpur
K. Mistry
Affiliation:
Prajna Health Care, Ahmedabad
M. Dutta
Affiliation:
Om Hospital, Raipur
A. Ramaraju
Affiliation:
Harshamitra Super Speciality Cancer Center and research institute, Trichy
S. B. Mangalwedhe
Affiliation:
Karnataka Institute of Medical Sciences, Hubli
S. G. Goyal
Affiliation:
S. P. Medical College & A.G. Of Hospitals, Bikaner
G. Kulkarni
Affiliation:
Manodnya Nursing Home, Sangli
A. Mukhopadhyay
Affiliation:
Nil Ratan Sircar Medical College and Hospital, Kolkata
P. Chaudhary
Affiliation:
GMERS Medical College, Ahmedabad
G. T. Harsha
Affiliation:
Rajlaxmi Hospital, Bangalore
M. Parikh
Affiliation:
B.J. Medical College and Civil Hospital, Ahmedabad
S. Dey
Affiliation:
Sparsh Hospital, Bhubaneswar
S. Sarkhel
Affiliation:
IPGME&R and SSKM Hospital, Kolkata
N. U. Jyothi
Affiliation:
Government General Hospital, Guntur
A. Kumar
Affiliation:
S N Medical College, Agra
N. K. Sooch
Affiliation:
Dayanand Medical College & Hospital, Ludhiana
A. Shetty
Affiliation:
Sun Pharma, Mumbai, India
S. Saha
Affiliation:
Sun Pharma, Mumbai, India
P. H. Devkare
Affiliation:
Sun Pharma, Mumbai, India
A. Shetty*
Affiliation:
Sun Pharma, Mumbai, India
D. Patil
Affiliation:
Sun Pharma, Mumbai, India
P. Ghadge
Affiliation:
Sun Pharma, Mumbai, India
A. Mane
Affiliation:
Sun Pharma, Mumbai, India
S. Mehta
Affiliation:
Sun Pharma, Mumbai, India
*
*Corresponding author.

Abstract

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Introduction

Lumateperone, an atypical antipsychotic drug, has a dual mechanism of action by combination of activity at central serotonin (5-HT2A) and dopamine (D2) receptors.

Objectives

This post-hoc analysis of an Indian Phase 3 study was conducted to evaluate the impact of Lumateperone 42mg compared to Quetiapine 300mg on severity of depression assessed via MADRS in patients with Bipolar II depression.

Methods

The phase-III, randomized, multi-centric, assessor-blind, parallel-group, active-controlled, comparative, non-inferiority study included patients with Bipolar II depression with moderate severity having a Montgomery-Asberg depression rating scale (MADRS) score ≥20 and Clinical global impression–bipolar version–severity (CGI-BP-S) score ≥4. The study was conducted after receiving regulatory and ethics committee approvals. The patients were randomized (1:1) to either receive Lumateperone 42mg [Test] or Quetiapine 300mg [Comparator] for 6 weeks. This post-hoc analysis evaluated MADRS total score and individual items from Question 1 to Question 10 i.e. (Q1) Apparent sadness; (Q2) Reported sadness; (Q3) Inner tension; (Q4) Reduced sleep; (Q5) Reduced appetite; (Q6) Concentration difficulties; (Q7) Lassitude; (Q8) Inability to feel; (Q9) Pessimistic thoughts; and (Q10) Suicidal thoughts respectively and for safety outcomes treatment emergent adverse events (TEAEs) were assessed. [Clinical trial registration: CTRI/2023/10/058583]

Results

This subgroup analysis included 462 patients, out of which 231 were in the Test group and 231 in the comparator group. The baseline demographic characteristics were comparable in between treatment arms. The reduction in MADRS score (total and individual items) from baseline to Day 42 in Test arm was comparable to Comparator arm [Figure 1 & 2]. The incidence of TEAEs were similar in both treatment arms [Test: 34.6%; Comparator: 35.5%] and no serious adverse events were reported.

Image 1:

Image 2:

Conclusions

This post-hoc analysis demonstrated that Lumateperone 42mg is comparable to Quetiapine 300mg in treatment of Bipolar II depression as assessed via MADRS score from baseline to Day 42, and both treatments were found to be well tolerated. Hence, Lumateperone can be considered as valuable treatment option in management of Bipolar II depression.

Disclosure of Interest

A. Dharmadhikari: None Declared, P. Chaurasia: None Declared, Y. Patel: None Declared, D. Choudhary: None Declared, P. Dasud: None Declared, M. Bhirud: None Declared, P. Meena: None Declared, F. Shah: None Declared, G. Ganesan: None Declared, B. P. Rathour: None Declared, K. Mistry: None Declared, M. Dutta: None Declared, A. Ramaraju: None Declared, S. Mangalwedhe: None Declared, S. G. Goyal: None Declared, G. Kulkarni: None Declared, A. Mukhopadhyay: None Declared, P. Chaudhary: None Declared, G. T. Harsha: None Declared, M. Parikh: None Declared, S. Dey: None Declared, S. Sarkhel: None Declared, N. Jyothi: None Declared, A. Kumar: None Declared, N. Sooch: None Declared, A. Shetty Employee of: Sun Pharma, S. Saha Employee of: Sun Pharma, P. Devkare Employee of: Sun Pharma, A. Shetty Employee of: Sun Pharma, D. Patil Employee of: Sun Pharma, P. Ghadge Employee of: Sun Pharma, A. Mane Employee of: Sun Pharma, S. Mehta Employee of: Sun Pharma.

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Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of European Psychiatric Association
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