Management of bipolar I depression: clinical utility of lurasidone

Abstract

Lurasidone is a benzisothiazol derivative second-generation antipsychotic. It has been approved in the United States and Europe for treatment of acute schizophrenia and bipolar depression. In type I bipolar subjects, treatment with lurasidone monotherapy of adjunctive therapy to lithium or valproic acid with doses of 20 to 120 mg once daily with food, results in statistically and clinically significant reduction of depressive symptoms. Patients experience relatively few side effects, which include somnolence, akathisia, nausea, and other gastrointestinal upset. Dopamine related side effects, such as Parkinsonism and elevated prolactin, are rare and mild. Longer term safety data obtained in 6 months long, open continuation observation periods, suggest that metabolic related elevations in weight, glucose, and lipids are absent or minimal. The mechanism of action of lurasidone is not known, but the data are compatible with antagonism of the serotonin 7 receptor. Lurasidone is a new option for the treatment of bipolar depression with relatively few side effects.

Keywords:

• lurasidone
• bipolar disorder
• bipolar depression
• adjunctive therapy

Disclosure

RSE has research funding from Merck and AssureRx. He is also a speaker for AstraZeneca, Lundbeck, Otsuka, Takeda, and Sunovion. Neither of the other authors have conflicts of interest to declare. This research was not funded by any extramural agency.