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Lurasidone » Athene

Posted by ed_uk2010 on October 5, 2014, at 15:01:40

In reply to Re: Lou's response-nhynwunwun, posted by Athene on October 5, 2014, at 9:22:42

Glad you stopped. How were the side effects when you were on ziprasidone (Geodon) 20mg?

As as a warning, beware of lurasidone (Latuda). It is a newer antipsychotic, related to Geodon. Neither drug causes much weight gain, but lurasidone has revealed a particularly high incidence of akathisia and EPS in clinical trials. The risk with Latuda is seemingly greater than Geodon and Risperdal. Funnily enough, lurasidone has essentially brought us an 'atypical' which produces a comparable incidence of acute EPS to good ole chlorpromazine (Thorazine).

Akathisia-wise, the only redeeming feature of lurasidone is that it doesn't cause as much or as severe akathisia/EPS as standard dose oral haloperidol (Haldol). Given that the risk of akathisia/EPS with haloperidol is probably the highest of any antipsychotic in use, the above is not exactly an achievement.

On the bright side, lurasidone users need not worry too much about their QTc interval or metabolic parameters......

Efficacy in schizophrenia has been demonstrated for lurasidone, after a fashion, but it doesn't appear to be as effective as most other atypicals. And a lot of patients dropped out of the trials.....

The situation of lurasidone receiving FDA approval for bipolar depression but not bipolar mania is a rarity for an antipsychotic. Wouldn't be surprised if the manufacturer did some preliminary trial in manic patients, struggled to find any evidence of efficacy, ended the trial as a bad job, and filed the results somewhere secure. Of course, it could have been entirely altruistic of them to search for a new treatment for bipolar depression, since there are already so many APs approved for mania. Something doesn't quite ring true though. The anti-manic efficacy of most APs can be demonstrated pretty clearly using trials of only a few weeks duration. The inevitable outcome is that most antipsychotics are approved for mania first and occasionally depression at a later date (schizophrenia approvals aside).

So, we have a new option, which is usually good. In this case, it equals less fat, at the cost of more frantic pacing. I expect it will eventually receive greater use as a low-dose 'adjunct' in mood disorders than in schizophrenia as the primary antipsychotic. After trying a few meds, docs and patients alike might notice that in spite of the reduced propensity to gain weight, lurasidone isn't actually treating the psychosis that well......

 

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poster:ed_uk2010 thread:1071828
URL: http://www.dr-bob.org/babble/20140914/msgs/1071883.html