lurasidone

Lurasidone is an atypical antipsychotic medication used to treat schizophrenia and depressive episodes associated with bipolar disorder. It is marketed under the brand name Latuda and by other manufacturers in various countries. Lurasidone acts mainly as a dopamine D2 and serotonin 5-HT2A receptor antagonist, with additional activity as a partial agonist at 5-HT1A and antagonism at 5-HT7 receptors. Its relatively low affinity for histamine H1 and muscarinic receptors contributes to a lower risk of weight gain and sedation compared with some other antipsychotics.

The drug is taken by mouth and absorption is enhanced when taken with food of at least about 350 calories. Lurasidone is metabolized in the liver primarily by the CYP3A4 enzyme, and its use can be affected by strong CYP3A4 inhibitors or inducers. Dosing commonly starts at 40 mg once daily with food, with titration to 80–160 mg daily based on response and tolerability. The maximum recommended daily dose is 160 mg.

Indications include schizophrenia in adults and adolescents, and depressive episodes associated with bipolar disorder. Lurasidone has a relatively favorable metabolic profile, but can cause extrapyramidal symptoms such as akathisia, as well as sleepiness, nausea, and headache. As with other antipsychotics, there is a risk of serious but uncommon adverse effects and a need for medical monitoring, including metabolic parameters and, when indicated, assessments for movement disorders.

Contraindications include hypersensitivity to lurasidone or its excipients. Caution is advised in hepatic impairment and in situations requiring avoidance or adjustment due to drug interactions, particularly with strong CYP3A4 inhibitors or inducers. Pregnancy category and breastfeeding considerations are to be discussed with a clinician.