Latuda (Lurasidone)

• Lurasidone is indicated for psychiatric conditions that involve dopamine and serotonin dysregulation.
• Schizophrenia: reduces positive and negative symptoms and helps prevent relapse in adult patients.
• Bipolar depression: alleviates depressive episodes in bipolar I disorder as an adjunct to mood stabilizers.
• Maintenance therapy: supports long‑term stability in schizophrenia when used as part of a maintenance regimen.

• Lurasidone exerts its antipsychotic effect primarily by antagonising dopamine D2 receptors and serotonin 5‑HT2A receptors, thereby reducing dopaminergic and serotonergic neurotransmission implicated in psychosis. It also acts as a partial agonist at 5‑HT1A receptors and an antagonist at 5‑HT7 receptors, which may contribute to its antidepressant and procognitive properties. The combined receptor profile modulates neuronal signalling in cortical and limbic pathways.

Lurasidone may cause a range of adverse reactions, varying from mild to serious.

Common Side Effects

• Nausea: mild gastrointestinal upset.
• Akathisia: inner restlessness and urge to move.
• Somnolence: drowsiness or fatigue.
• Weight gain: modest increase in body weight.

Serious or Rare Side Effects

• Neuroleptic malignant syndrome: life‑threatening reaction with fever and muscle rigidity.
• Tardive dyskinesia: persistent involuntary movements, especially of the face.
• Suicidal thoughts: emergence or worsening of suicidal ideation.

When prescribing lurasidone, clinicians should consider several safety precautions.

• Pregnancy: safety not established; use only if potential benefit justifies risk.
• Breastfeeding: unknown excretion; weigh benefits against possible infant exposure.
• Elderly: monitor for cerebrovascular events and orthostatic hypotension.
• Metabolic monitoring: assess weight, glucose and lipid levels periodically.
• Cardiac: obtain baseline ECG and monitor QT interval, especially with other QT‑prolonging agents.
• Store at ambient temperature below 25 °C: keep tablets in original packaging, protect from moisture and light.

Lurasidone is metabolised mainly by CYP3A4, so co‑administered drugs can alter its plasma concentrations.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin): may increase lurasidone exposure and risk of toxicity.
• Strong CYP3A4 inducers (e.g., rifampin, carbamazepine): may reduce lurasidone levels and compromise efficacy.
• Concomitant use with other antipsychotics: can heighten risk of QT prolongation and extrapyramidal symptoms.

Moderate Interactions (Monitor Closely)

• Serotonergic agents (SSRIs, SNRIs, tramadol): may increase risk of serotonin syndrome.
• CNS depressants (alcohol, benzodiazepines): may enhance sedation and impair psychomotor performance.
• Antihistamines (diphenhydramine): may increase somnolence.