Lurasidone
Latuda
Second-Generation AntipsychoticGeneric availableTDM data
The mechanism of action of lurasidone in the treatment of schizophrenia and other indication is unclear. However, its efficacy in schizophrenia and other indication could be mediated through a combination of central dopamine D2 and serotonin Type 2 (5HT2A) receptor antagonism.
Compare Lurasidone →FDA-Approved Indications
- Schizophrenia (adults; adolescents 13–17 years)
- Bipolar I depression — monotherapy (adults; pediatric 10–17 years)
- Bipolar I depression — adjunct to lithium/valproate (adults)
Common Off-Label Uses
- Treatment-resistant depression (adjunct)
- Schizoaffective disorder
What Sets This Drug Apart
- Lowest metabolic burden among SGAs: glucose P-score 0.09 (lowest in Pillinger NMA), negative glucose point estimate, and lower-quartile rankings across all 7 metabolic axes
- Must take with food (at least 350 calories) — absorption doubles with food; non-adherence to this requirement is a leading cause of treatment failure
- FDA-approved for bipolar depression as both monotherapy and adjunctive with lithium/valproate (adults and pediatric 10-17)
- Negative QTc signal in NMAs (Huhn MD -2.21 ms; Leucht MD -1.18 ms) — label has no QT-prolongation warning section
- Akathisia is the signature tolerability concern (22% at 120 mg, highest among metabolically favorable SGAs)
- CYP3A4 substrate, contraindicated with strong CYP3A4 inhibitors (ketoconazole) and strong inducers (rifampin); moderate inhibitors require 50% dose reduction
Boxed Warning
WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA‐RELATED PSYCHOSIS