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Brand name Latuda®
Generic name Lurasidone
What is lurasidone and what does it treat?
Lurasidone is a medication that works in the brain to treat schizophrenia. It is also known as a second generation antipsychotic (SGA) or atypical antipsychotic.
There are many different symptoms of schizophrenia. Hallucinations are imagined voices or images that seem real. Delusions are beliefs that are not true (e.g., other people are reading your thoughts). Disorganized thinking involves trouble organizing your thoughts and making sense. Others may have little desire to be around other people, trouble speaking clearly, and lack of motivation. Lurasidone may help some or all of these symptoms.
What is the most important information I should know about lurasidone?
Do not stop taking lurasidone or change your dose without first talking to your healthcare provider.
Lurasidone is used for long-term treatment of schizophrenia.
Do not stop taking lurasidone, even when you feel better. Only your healthcare provider can determine the length of lurasidone treatment that is right for you.
Missing doses of lurasidone may increase your risk for a relapse in your symptoms.
For lurasidone to work properly, it should be taken everyday as ordered by your healthcare provider.
Are there specific concerns about lurasidone and pregnancy?
If you are planning on becoming pregnant, notify your healthcare provider to best manage your medications. People living with schizophrenia who wish to become pregnant face important decisions. This is a complex decision since untreated schizophrenia has risks to the fetus as well as the mother. It is important to discuss the risks and benefits of treatment with your doctor and caregivers.
Breast-feeding is not recommended in women who are taking lurasidone.
What should I discuss with my healthcare provider before taking lurasidone?
Symptoms that are most bothersome to you about your condition
If you have thoughts of suicide
Medications you have taken in the past to treat schizophrenia and if they were effective or caused any adverse effects
If you ever had muscle stiffness, shaking, tardive dyskinesia, neuroleptic malignant syndrome, weight gain, or diabetes caused by a medication
Any psychiatric or medical problems you have, such as heart rhythm problems, long QT syndrome, heart attacks, diabetes, high cholesterol or seizures
If you have a family history of diabetes or heart disease
All other medications you are currently taking (including over the counter products, herbal and nutritional supplements) and any medication allergies you have
Other non-medication treatment you are receiving (such as psychotherapy (i.e., talk therapy) or substance abuse treatment). Your provider can explain how these different treatments work with the medications.
If you are pregnant, plan to become pregnant, or are breast-feeding
If you smoke, drink alcohol, or use illegal drugs
How should I take lurasidone?
Lurasidone is usually taken once daily. It must be taken with food (at least 350 calories) to work properly.
The most common dose of lurasidone is 40 mg or 80 mg. Only your healthcare provider can determine the correct dose for you.
Use a calendar or pillbox to help you remember to take your medication. You may also ask a family member or friend to remind you or check in with you to be sure you are taking your medication.
What happens if I miss a dose of lurasidone?
If you miss a dose of lurasidone, take it as soon as you remember it, if it is not too close to when your next dose is due. Discuss this with your healthcare provider. Do not double your next dose or take more than what is prescribed.
What should I avoid while taking lurasidone?
Avoid drinking alcohol or using illegal drugs while you are taking lurasidone. They may decrease the benefits (e.g., worsen your confusion) and increase adverse effects (e.g., sedation) of the medication.
What happens if I overdose with lurasidone?
If an overdose occurs call your doctor or 911. You may need urgent medical care. You may also contact the poison control center at 1 (800) 222-1222.
A specific antidote for lurasidone does not exist.
What are possible side effects of lurasidone?
Common Side Effects
Side effects are usually relatively minor and include restlessness, agitation and upset stomach.
Rare Side Effects
Lurasidone may increase the blood levels of a hormone called prolactin. Side effects of increased prolactin levels include females losing their period, production of breast milk and males losing their sex drive or possibly experiencing erectile problems. Long term (months or years) of elevated prolactin can lead to softer bones, osteoporosis or increased risk of bone fractures.
Serious Side Effects
Some people may develop muscle related side effects while taking lurasidone. The technical terms for these are “extrapyramidal effects” (EPS) and “tardive dyskinesia” (TD). Symptoms of EPS include restlessness, tremor, and stiffness. TD symptoms include slow or jerky movements that one cannot control, often starting in the mouth with tongue rolling or chewing movements.
Second generation antipsychotics (SGAs) increase the risk of weight gain, high blood sugar, and high cholesterol. This is also known as metabolic syndrome. Your healthcare provider may ask you for a blood sample to check your cholesterol, blood sugar, and hemoglobin A1c (a measure of blood sugar over time) while you take this medication.
For more information including ideas for healthy eating and exercise, see the NAMI Hearts and Minds Program. For the relative risk of each medication and monitoring recommendations, see Table 2 in the Consensus Conference on Antipsychotic Drugs.
SGAs have been linked with higher risk of death, strokes and transient ischemic attacks (TIAs) in elderly people with behavior problems due to dementia.
All antipsychotics have been associated with the risk of sudden cardiac death due to an arrhythmia (irregular heart beat). To minimize this risk, antipsychotic medications should be used in the smallest effective dose when the benefits outweigh the risks. Your doctor may order an EKG to monitor for irregular heart beat.
Neuroleptic malignant syndrome is rare, life threatening adverse effect antipsychotics which occurs in <1% of patients. Symptoms include confusion, fever, extreme muscle stiffness and sweating. If any of these symptoms occur, contact your healthcare provider immediately.
Are there any risks for taking lurasidone for long periods of time?
Tardive dyskinesia (TD) is a side effect that develops with prolonged use of antipsychotics. Medications such as lurasidone have been shown to have a lower risk of TD compared to older antipsychotics, such as Haldol® (haloperidol). If you develop symptoms of TD, such as grimacing, sucking and smacking of lips, and other movements that you cannot control, contact your healthcare provider immediately. All patients taking either first or second generation antipsychotics should have routine Abnormal Involuntary Movement Scale (AIMS) completed by their healthcare professional to monitor for TD.
Second generation antipsychotics (SGAs) increase the risk of diabetes, weight gain, high cholesterol and high triglycerides. (See “Serious Side Effects” for monitoring recommendations.)
What other medications may interact with lurasidone?
Lurasidone may block the effects of agents used to treat Parkinson’s disease such as levodopa/carbidopa (Sinemet®), bromocriptine, pramipexole (Mirapex®), ropinirole (Requip®) and others.
The following medications are contraindicated (i.e., should not be used) in patients taking lurasidone: ketoconazole (Nizoral®), fluvoxamine (Luvox®) and rifampin (Rifadin®).
The following medications may increase the levels and effects of lurasidone: diltiazem (Cardizem®), erythromycin (Ery-Tab®) and fluconazole (Diflucan®). Grapefruit juice may also increase levels of lurasidone.
The following medications may decrease the levels and effects of lurasidone: carbamazepine (Tegretol®) and phenobarbital.
Lurasidone may lower your blood pressure. Medications used to lower blood pressure may increase this effect and increase your risk of falling. Propranolol (Inderal®) is an example of this type of medication.
Tell your doctor if you begin or discontinue any of these medications.
How long does it take for lurasidone to work?
Lurasidone rebalances dopamine and serotonin to improve thinking, mood, and behavior. Improvement of some symptoms may be noticed in some patients within a few weeks. The full benefit of lurasidone may not be seen for 6-12 weeks or longer.
FDA ALERT 6/6/2008
Both first generation (typical) and second generation (atypical) antipsychotics are associated with an increased risk of mortality in elderly patients treated for dementia related psychosis. Antipsychotics are not indicated for the treatment of dementia-related psychosis.
Provided by College of Psychiatric and Neurologic Pharmacists, July 2012
Reviewed by Ken Duckworth, M.D., NAMI Medical Director; NAMI January 2013; June 2017