side effects, dosage, reviews, how to take & discontinue, uses, pros & cons, and more
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Brand & Generic Names; Drug Classes; Availability & Forms
|US brand name: Latuda|
|Generic name: lurasidone|
|Primary drug class: Antipsychotics|
|Additional drug class(es): Second Generation Antipsychotic / Atypical Antipsychotic (SGA / AAP), MoodStabilizers, Antidepressants|
Generic and Overseas Availability
|Available as a generic? No|
Other Trade Names and Overseas Availability
|Available in Canada as Latuda. Approval pending in Britain, Ireland, the EU, and Japan. That last one is funny since it was developed in Japan long before it was approved in the US.|
Shapes & Sizes (How Supplied)Tablets. 20, 40, 80 & 120 mg.
Approved & Off-Label Uses (Indications)
Latuda’s US FDA Approved Treatment(s)
- Bipolar Depression (officially: Depressive episodes associated with Bipolar I Disorder)
Uses Approved Overseas but not in the US
Off-Label Uses of Latuda
- Bipolar 2 (seriously, that’s an off-label prescription)
- as a full-on Bipolar mood-stabilizer
- As an add-on to an antidepressant to treat depression
When & If Latuda Will Work
Latuda’s Usual Onset of Action (when it starts working)
Like most antipsychotics you should feel Latuda doing something positive within one or two days.
Likelihood of Working
I’m still researching this.
Taking and Discontinuing
How to Take Latuda
The recommended starting dose of LATUDA is 40 mg once daily. Initial dose titration is not required. LATUDA has been shown to be effective in a dose range of 40 mg/day to 160 mg/day. The maximum recommended dose is 160 mg/day.
Given how freaking potent Latuda is, and that they make a 20mg tablet, starting with 20mg is something worth discussing with your doctor. It all depends on how crazy you are at the moment, or if you’re currently taking an antipsychotic and the plan is to switch you to Latuda.
You must take Latuda with food, at least 350 calories. Sunovion has now spelled out this requirement as clearly as Pfizer has with Geodon. If you don’t take your Latuda with food it’s the same as if you’re taking a little less than half of your dosage.
While it’s usually a toss-up as to if you should take some in the morning or at night, based on what little I’ve found out, start by taking it in the morning. Latuda might still put you to sleep, but the odds are in favor of it waking you up more than knocking you out.
How to Stop Taking Latuda (discontinuation / withdrawal)
Reduce your dosage by 20 to 40mg a day every five days to a week.
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Latuda’s Pros and Cons
- Latuda’s mechanisms of action promise fewer of the annoying side effects associated with SGAs/AAPs, especially weight gain and the anticholinergic side effects.
- For a medication with such potent anti-dopamine action, Latuda had surprisingly little affect on prolactin, blood sugar, cholesterol, and triglycerides. For many people in the clinical trials and follow-up studies, Latuda actually lowered the amount of bad cholesterol and triglycerides.
- As one of the few crazy meds with a pregnancy category of B Latuda is safer to take than than practically every other drug discussed on this site if you’re considering to get, or happen to become, pregnant.
- Any antipsychotic with no anticholinergic side effects is more likely to cause movement disorders.
- When it comes to side effects, the results from clinical trials and follow-up studies don’t always map to reality.
- While it didn’t affect their little babies, noticeably more female mice given the equivalent of a human taking the maximum dosage 160mg a day developed the rodent equivalent of breast cancer.
Interesting Stuff your Doctor Probably didn’t Tell You
Best Known for
Latuda’s Side Effects
Typical Side EffectsMovement disorders. Movement disorders galore. 20–40% of the people in the clinical trials had some form of movement disorder, and the rate of side effects in clinical trials are almost always lower than real life. Nausea and other GI problems are common, but that’s often the case with any made you really need to take with food. Putting you to sleep and making you feel tired throughout the day is also common, but Latuda’s an antipsychotic, so what can you expect?
Uncommon Side Effects
Freaky Rare Side Effects
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What You Really Need to be Careful About
B-proven safe, but not as well tested as A
Latuda’s Half-Life & How Long Until It Clears Your System
Plasma half-life: 18 hours. Cleared in approximately 5 days.
Half-life is the average time it takes for you to process half of the drug’s active ingredient. If a drug has a half-life of around 24 hours and you take a dose of 100mg, you’ll have roughly the equivalent a 50mg dose after one day, a 25mg dose after two days, and so on. The rule of thumb is: multiply the half-life by five and you get how long it is for the dose you took to be cleared from your bloodstream1, so there’s nothing swimming around to attach itself to your brain and start doing stuff. That’s called “plasma clearance.” Complete clearance is a complex equation based on a lot of factors which may or may not: be published in the PI sheet, include personal data like your weight, or even completely figured out by corporate and independent researchers. It usually winds up being 2–5 days after plasma clearance no matter what2, but can take weeks. Sometimes a drug will clear from your brain and other organs before it clears from your blood.
Steady state is the flipside of half-life. This is when you can expect to get over side effects caused by fluctuating amounts of a medication in your bloodstream. Often, but not always the same amount of time as the plasma clearance above.
How lurasidone Works
the current best guess at any rateAccording to Sunovion, the same as all SGAs / AAPs when it comes to schizophrenia:
[T]hrough a combination of central dopamine Type 2 (D2) and serotonin Type 2 (5HT2A) receptor antagonism. —Latuda PI sheet
In English: Blocking excess brain juice at the bits of your brain responsible for both the positive symptoms (the dopamine receptors) of schizophrenia, like delusions and hallucinations, and its negative symptoms and bipolar depression (the serotonin receptors). The effect on
Latuda is a really potent D2 antagonist. It’s also a really potent 5HT7 antagonist, which explains why it knocks some people out when it doesn’t touch H1 histamine receptors. Like Saphris, Latuda doesn’t touch M1 muscarinic receptors. Latuda is also a moderate partial 5HT1A agonist like Geodon and Seroquel. Latuda’s effect on 5HT1A, 5HT2A and 5HT7 explain why it’s a pretty good antidepressant and helps with negative symptoms.
The active ingredient is usually the same as the generic name, but more often than not it’s a chemical salt of the substance identified as the generic. E.g. Fluoxetine is the generic for Prozac, but the active ingredient is fluoxetine hydrochloride (or HCl). It usually doesn’t make much of a difference outside of the more esoteric aspects of a drug’s pharmacology, but not always.
Noted Drug-Drug & Drug-Food Interactions
Don’t even think about drinking grapefruit juice, eating grapefruit, or anything else discussed on our page about such things. That goes double for taking meds that inhibit or induce CYP3A4.
Check for Other Drug-Drug & Drug-Food Interactions
It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on te Faecesbooks.
Comments, PI Sheet, Ratings, Reviews and More
CommentsLike most of Crazymeds, this article isn’t done. I was most of the way through when my life fell apart on 2 September 2013. As it has been in the wiki’s directory and publicly readable, Google and everyone else on the planet could find it. Given the ratings the article has received, I’m putting out here and working on it when I can.
Latuda was approved by the FDA to treat schizophrenia 28 October 2010 and bipolar depression 28 June 2013.
I’ve got to give props to Sunovion for how well the official Latuda site is geared towards the schizophrenic community, with families & caregivers as an adjunct, but still out in the open. In the way people with all sorts of brain cooties are encouraged to have a support network who aren’t afraid to be associated with them. Like similar well-made sites (e.g. the Invega Sustenna site), the Latuda site treats the schizophrenic as adults, able to read at a high-school level, and capable of making their own decisions when it comes to medication.
Now that Latuda has been approved to treat bipolar depression, the schizophrenia part of the site has been relegated to a subdirectory, with a small link to it on the all about bipolar home page. That’s not surprising. There’s a shitload more money in bipolar than there is in schizophrenia.
On the flip side, their site for health care professionals is creepy. Why? Compare the pictures of schizophrenic guy on both sites. If that is how some doctors see us, maybe they need to be taking 20mg of Latuda a day as well. On the plus side, Sunovion made available the results from the clinical trials that got Latuda FDA approval. While not as transparent as I’d like, it’s still better than nothing.
Latuda’s side effect profile is really odd. For a drug that kicks practically everyone’s ass at D2 (only some of the older APs like fluphenazine and thiothixene are more potent), and has the highest rates for movement disorders I’ve seen in a PI sheet, yet has, based on the information available so far, surprisingly little affect on prolactin, blood sugar, cholesterol, and triglycerides. I’m trying to wrap my head around that one. Maybe its (literally) shitty pharmacokinetics causes all that D2 action to bypass the pancreas and liver. Maybe it manages to exert its action at the serotonin receptors there much better than other APs, compensating for the D2 antagonism. Maybe some of both. Maybe it’s something else entirely - like Stahl’s “x-receptor,” an as-yet-discovered receptor, or property of a known receptor, that affects metabolic functions.
On the subject of side effects, here’s a great bit of refreshing honesty from a drug company:
There is an unmet need in the treatment of schizophrenia for effective medications with fewer adverse effects. --Lurasidone in the treatment of schizophrenia: a 6-week, placebo-controlled study
Too bad the adverse reactions the R&D guys at Dainippon Sumitomo focused on were EPS and other movement disorders. Ooops. No wonder only a third of the people in the study completed it. And Latuda was approved in the US before Japan, where it was developed.
The activity of LATUDA is primarily due to the parent drug. The pharmacokinetics of LATUDA is dose-proportional within a total daily dose range of 20 mg to 160 mg. Steady-state concentrations of LATUDA are reached within 7 days of starting LATUDA.
Following administration of 40 mg of LATUDA, the mean (%CV) elimination half-life was 18 (7) hours.
Absorption and Distribution: LATUDA is absorbed and reaches peak serum concentrations in approximately 1–3 hours. It is estimated that 9–19% of an administered dose is absorbed. Following administration of 40 mg of LATUDA, the mean (%CV) apparent volume of distribution was 6173 (17.2) L. LATUDA is highly bound (~99%) to serum proteins.
In a food effect study, LATUDA mean Cmax and AUC were about 3-times and 2-times, respectively, when administered with food compared to the levels observed under fasting conditions. LATUDA exposure was not affected as meal size was increased from 350 to 1000 calories and was independent of meal fat content [see Dosage and Administration (2.2)].
In clinical studies, establishing the safety and efficacy of LATUDA, patients were instructed to take their daily dose with food [see Dosage and Administration (2.2)].
Metabolism and Elimination: LATUDA is metabolized mainly via CYP3A4. LATUDA is metabolized into two active metabolites (ID-14283 and ID-14326) and two major non-active metabolites (ID-20219 and ID-20220).
Total excretion of radioactivity in urine and feces combined was approximately 89%, with about 80% recovered in feces and 9% recovered in urine, after a single dose of [14C]-labeled LATUDA.
Following administration of 40 mg of LATUDA, the mean (%CV) apparent clearance was 3902 (18.0) mL/min.
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If you’re still feeling judgmental as well as just mental3, please boost or destroy my self-confidence by honestly (and anonymously) rating this article on a scale of 0 to 5. The more value-judgments the better, even if you can criticize my work only once.
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BibliographyStahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications (Essential Psychopharmacology Series) Third edition by Stephen M. Stahl © 2008 Published by Cambridge University Press. Stahl’s Illustrated Antipsychotics: Treating Psychosis, Mania and Depression Second Edition by Stephen M. Stahl and Laurence Mignon © 2010 Published by Cambridge University Press. Latuda PI sheet Lurasidone for Schizophrenia: A Brief Review of a New Second-Generation Antipsychotic Lurasidone in the Treatment of Schizophrenia: A Randomized, Double-Blind, Placebo- and Olanzapine-Controlled Study Clinical potential of lurasidone in the management of schizophrenia Pharmacological Profile of Lurasidone, a Novel Antipsychotic Agent with Potent 5-Hydroxytryptamine 7 (5-HT7) and 5-HT1A Receptor Activity Update on the development of lurasidone as a treatment for patients with acute schizophrenia Lurasidone HCl (Latuda), an Oral, Once-Daily Atypical Antipsychotic Agent for the Treatment of Patients with Schizophrenia
2 For crazy meds. I have no idea what the average complete clearance is for other types of medications. For all I know there are drugs that utterly vanish from your system in under five passes, and others that won't let go of your squishy bits for years after you stop taking them.
3 Thank you! I'll be here all weak. Be sure to tip your content provider. And don't try the veal, it's cruelicious!
I welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why I write these damn things. I’m frustrated enough as it is. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds.
|Last modified on Tuesday, 04 March, 2014 at 11:24:40 by SomeMedCritic||Page Author: Jerod Poore||Date created Tuesday, 14 May 2013 at 09:18:44|
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Almost all of the material on this site is by Jerod Poore and is copyright © 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, and 2014 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and the following disclaimer, I’m usually cool with it.
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The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else.
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Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained through our personal experience and the experiences family, friends, what people have reported on various reputable sites all over teh intergoogles, the medications’ product information / summary of product characteristic (PI/SPC) sheets, and from sources that are referenced throughout the site. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or patient information leaflet (PIL) that comes with your medications and never ever throw them away.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
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Crazymeds is optimized for the browser you’re not using on the platform you wish you had. Between you and me, it all looks a lot cleaner using Safari or Chrome, although more than half of the visitors to this site use either Safari or Internet Explorer, so I’m doing my best to make things look nice for IE as well. I’m using Firefox and running Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazymeds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
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1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?
[begin rant] I rent a dedicated server for Crazymeds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had a forerunner of QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]