The Food and Drug Administration (FDA) has approved a new atypical antipsychotic, lurasidone (Latuda), which comes in tablet form, for the treatment of adults with schizophrenia. Lurasidone is a dopamine-receptor (specifically D2) blocker, as well as an inhibitor of serotonin 5-hydroxytryptamine (5-HT) receptor subtype 5-HT2A. The effect on schizophrenia is believed to come from blockade of these two receptors. In clinical trials conducted prior to approval, lurasidone was found to be more effective than placebo in preventing schizophrenia symptoms. The four clinical trials examining lurasidone's effectiveness were all of short duration; no information on long-term use of the drug is available. One of those trials used olanzapine as an active control, and lurasidone wasn't found to be superior to it.
Lurasidone carries the same black box warning all atypical antipsychotics do, stating that the drug increases the risk of death, especially from cerebrovascular adverse effects, including stroke, in older adults with dementia-related psychosis. Like other atypical antipsychotics, lurasidone isn't approved for treatment of that type of psychosis. It also has the same adverse effects profile as other atypical antipsychotics: weight gain and elevated blood glucose and blood lipid levels. Like other D2-receptor blockers, it can produce hyperprolactinemia.
Lurasidone is metabolized predominantly by the cytochrome P-450 (CYP) enzyme system, specifically the isoenzyme CYP3A4; drugs that induce or are strong inhibitors of this isoenzyme will likely alter the circulating level of lurasidone and shouldn't be used.
Patient education for those receiving lurasidone should be similar to that given to patients receiving other atypical antipsychotics.