Atlura (lurasidone) is an atypical antipsychotic predominantly used to treat schizophrenia and depressive episodes associated with bipolar I disorder.

This product is among the few antipsychotic medications that provides significant benefit in treating depressive episodes associated with bipolar I disorder.

Atlura should not be used in patients with mental retardation, dementia, Alzheimer's disease, or brain damage due to injury. The medication is unlikely to provide benefits that outweigh the risks.

This is a relatively new medication, first available in the 2010s. As an atypical antipsychotic it works somewhat differently than typical antipsychotics; it may provide benefit where typical antipsychotics have failed, and may not produce the same side effects.

What to Expect from Atlura

Like most antipsychotics Atlura helps patients stay grounded in reality. While some symptoms may persist, they should be milder and patients are much better able to recognize them as symptoms and not act on them. Impulse control is also improved, allowing patients to prevent themselves from acting out in dangerous, destructive, or embarrassing ways.

Commonly reported benefits include:

• Fewer delusions or hallucinations
• Less erratic or bizarre behavior
• Improved mental focus
• Better clarity and control of thoughts
• Fewer mood swings
• Improved impulse control

Atlura also offers some significant benefits when compared to other antipsychotics used for similar purposes:

• Much less likely to cause weight gain.
• Much less likely to cause QT interval (heart rhythm) changes.
• Somewhat less likely to have a sedative effect.

Atlura also has its drawbacks. A rare but concerning risk from all antipsychotics is extrapyramidal symptoms (EPS); a range of movement disorders. There is an association with EPS being more likely to develop with higher doses and longer-term treatment in all antipsychotics. In many cases, but unfortunately not all, symptoms will reverse if treatment stops. Warning symptoms include:

• Tremors
• Rapid or irregular breathing
• Uncontrolled movements of the head, limbs, back, or face
• Excessive pacing or foot-tapping
• Muscle stiffness or rigidity
• No arm movement when walking
• Inability to make facial expressions
• Drooling

Patients or caretakers should be alert for the above symptoms and seek medical attention at the earliest signs something is wrong.

Dosage & Administration

Atlura is administered by tablet, typically just once per day. It should always be taken with food; a minimum of 350 calories is recommended. Taking with food substantially improves absorption of the medication.

Treatment is always individualized according to patient variables and patient response. Dosage may need to be adjusted several times at the start of treatment before an effective dose is found.

In both schizophrenia and depression associated with bipolar I disorder, dosage typically starts on the lower end of 20 to 40 mg per day, which may be increased, if needed, up to 160 mg per day, though such high doses are unusual.

Other medications to treat the same condition may be given along with Atlura, particularly in treating depression associated with bipolar I disorder; lithium or valproate are commonly used at the same time.

Some benefit is often felt within a day or two of starting treatment, but it may take longer for full benefit to be felt. Duration of treatment will vary between patients and should be determined by a doctor on a case-by-case basis.

Precautions & Side Effects

Most patients experience only mild side effects from Atlura if taken as directed. These side effects often stop occurring over the first week or two of treatment. Most common are:

• Restlessness
• Diarrhea
• Drowsiness
• Stomach upset
• Vomiting
• Dry mouth

If the above become severe enough to be disruptive or persist past the first few weeks of treatment a doctor should be consulted.

Atlura can interact with a wide range of other medications, including some over-the-counter medications. Check with a doctor or pharmacist before taking any other medication for the duration of treatment.