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Latuda (lurasidone) is an antipsychotic medication most commonly used in schizophrenia, but increasingly used to treat depressive episodes associated with bipolar I disorder; in fact it is one of very few antipsychotic medications that provides significant benefit in that application.

Pros & Cons of Latuda

Introduced in the early 2010s, Latuda is a relatively new medication. It is an atypical antipsychotic, meaning it works somewhat differently than typical antipsychotics and doesn't fit well into their classes. It also means it may provide benefit where typical antipsychotics have failed, and may not produce the same side effects even if it provides the same benefit.

Comparing Latuda with other antipsychotics, Latuda has generally shown to be:

• Much less likely to cause weight gain.
• Least likely to cause QT interval (heart rhythm) changes.
• Somewhat less likely to have a sedative effect.
• Somewhat more likely to cause extrapyramidal symptoms (movement disorders).

Extrapyramidal symptoms (EPS) are rare, but they are a concern with all antipsychotics; the term refers to 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. Patients should be alert for symptoms developing and seek medical attention at the earliest signs something is wrong:

• Tremors
• Rapid or irregular breathing
• Uncontrolled movements of 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 taking Latuda can expect:

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

Latuda 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.

Treatment Basics

Treatment will vary to some extent depending on the condition being treated, its severity, and of course patient response. 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.

Doses are usually taken just once per day, with food---at least 350 calories is recommended---as food significantly increases absorption of the medication. Some effects may be seen 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.

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

Precautions & Side Effects

Taken as directed, most patients experience only mild side effects from Latuda, and 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

Patients with other medical conditions are at increased risk of experiencing serious complications. Discuss risks and warning signs carefully with a doctor before taking Latuda if there is any history of:

• Liver or kidney disease
• Diabetes
• Seizures
• Blood or bone marrow disorders
• Parkinson's disease
• Breast cancer
• Difficulty swallowing
• Any cardiovascular issues
• Any motor or muscle control issues

Latuda 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.