Lurasidone: a review of its use in adult patients with bipolar I depression

CNS Drugs. 2015 Mar;29(3):253-63. doi: 10.1007/s40263-015-0234-2.

Abstract

Lurasidone (Latuda(®)), a benzisothiazole derivative antipsychotic, is approved in the USA and Canada for the treatment of adults with major depressive episodes (MDE) associated with bipolar I disorder; this article reviews studies of lurasidone in this indication. In two 6-week, placebo-controlled trials in adults with bipolar I depression, lurasidone 20-120 mg/day reduced depressive symptoms, either as monotherapy or as an adjunct to lithium or valproate. Lurasidone reduced the mean Montgomery-Åsberg Depression Rating Scale (MADRS) total score from baseline (primary endpoint) by >50 %; the reductions in scores were significantly greater than with placebo. The treatment effects were small to medium and the numbers needed to treat to obtain an additional MDE response (≥50 % reduction from baseline in the MADRS total score) were ≤7 across the lurasidone groups. In a third, similarly designed trial of lurasidone 20-120 mg/day adjunctive to lithium or valproate, there was no significant between-group difference in the change in the mean MADRS total score at week 6 (primary endpoint), although significant differences favouring lurasidone were observed from week 2 to week 5. Across trials, the most frequently occurring adverse events included akathisia, extrapyramidal symptoms and somnolence. Lurasidone had a favourable profile with respect to weight gain and metabolic disturbances, known to occur with some other antipsychotics. Thus, lurasidone offers a valuable addition to the therapies available for adult patients with bipolar depression, either as monotherapy or as an adjunct to lithium or valproate.

Publication types

  • Review

MeSH terms

  • Adult
  • Bipolar Disorder / drug therapy*
  • Clinical Trials as Topic
  • Drug Therapy, Combination
  • Humans
  • Lithium Compounds / administration & dosage
  • Lurasidone Hydrochloride / administration & dosage*
  • Lurasidone Hydrochloride / adverse effects
  • Psychotropic Drugs / administration & dosage*
  • Psychotropic Drugs / adverse effects
  • Valproic Acid / administration & dosage

Substances

  • Lithium Compounds
  • Psychotropic Drugs
  • Valproic Acid
  • Lurasidone Hydrochloride