Mental health issues may still be stigmatized in the United States, but they affect many people. According to the National Alliance on Mental Illness, an estimated one in five adults in the United States experience mental illness, and one in 25 adults experience serious mental illness.
The problem is not just limited to older adults; 17 percent of children between the ages of 6 and 17 experience a mental health disorder.
Two of the more serious types of mental illness are schizophrenia and bipolar disorder, which affect one percent and three percent of the American adult population each year.
People who have been diagnosed with these medical conditions may have heard about a medication called Latuda that can provide relief from their symptoms when taken consistently.
So, what is Latuda and how can it help people with serious mental illness?
What Is Latuda?
Latuda is a Food and Drug Administration (FDA)-approved medication that is sometimes referred to by the name of its active ingredient, lurasidone.
Latuda belongs to a class of drugs called atypical antipsychotics and is approved for use in children over the age of 10 or 13, depending on the condition being treated.
Typical antipsychotics block the action of dopamine in the brain, while atypical antipsychotics block both dopamine and serotonin.
Therefore, atypical antipsychotics can sometimes be used in the treatment of certain types of depression, as well as other serious mood disorders.
What Is Latuda Used to Treat?
Latuda was first approved by the FDA in 2010 for the treatment of schizophrenia, and in 2013, it was approved for the treatment of bipolar depression.
Both conditions are serious mental health conditions that require consistent treatment.
Schizophrenia
Schizophrenia is a mental illness that is characterized by a number of symptoms that can be extremely troubling and disruptive to the person who has it.
People with schizophrenia struggle to think clearly, have difficulty managing their emotions and may find it challenging to make decisions or relate to other people.
Most diagnoses of schizophrenia in men during the teenage years or the early 20s, while women are typically diagnosed in their late 20s or early 30s.
It is believed that genetics, family history, environmental exposure to viruses or malnutrition in utero, brain chemistry issues, and substance abuse can be considered inducers to the onset of schizophrenia.
Symptoms of schizophrenia include:
- Hallucinations: hearing voices or seeing things that seem real but are not there
- Delusions: holding beliefs that are not true, like the belief that someone is trying to read your mind
- Trouble organizing your thoughts and speaking clearly
- Withdrawal from other people
- Difficulty speaking clearly
- Lack of motivation
Bipolar Depression
Many people are familiar with bipolar I disorder, which is characterized by shifting moods, energy, and activity levels.
During periods of mania, people with bipolar disorder may feel elated, energized, and irritable, while during periods of depression, they may feel sad, hopeless, or indifferent.
Bipolar depression refers to the depressive phase of bipolar disorder, and it is different from chronic unipolar depression because patients experience extreme lows followed by periods of extreme highs, whereas those with unipolar depression experience more consistent lows.
Bipolar depression has proven to be more difficult to treat than unipolar depression, and it does not typically respond to antidepressants that are effective for other types of depression including Risperidone, Aripiprazole, and Olanzapine.
How Does Latuda Work?
As an atypical antipsychotic drug, Latuda works differently than other medications used to treat depression and psychosis.
The active ingredient in Latuda, lurasidone, works by acting on receptors for some of the neurotransmitters in the brain. Specifically, lurasidone blocks the receptors for dopamine, serotonin, and noradrenaline.
It is thought that people with schizophrenia and bipolar depression may have too much of these neurotransmitters. By blocking the receptors, lurasidone is able to reduce symptoms and normalize brain activity.
However, scientists still don’t understand exactly what causes schizophrenia and bipolar depression, so the exact mechanism by which Latuda works is somewhat unknown.
How Much Does Latuda Cost?
One of the biggest downsides to Latuda is the cost. Because the medication is still being manufactured under the original patent by Sunovion Pharmaceuticals Inc., there are currently no generic versions of the drug available and prices remain extremely high.
A 30-day supply of the medication at a 40 mg strength costs nearly 1,300 dollars, putting the medication out of reach of many Americans.
Latuda is covered by Medicare and Medicaid as well as many commercial insurance programs, but other insurance programs may not cover the medication.
The manufacturer offers a savings program on their website for patients with commercial insurance who do not receive coverage for the medication and patients without insurance.
Compared to other drugs in its class, Latuda has the lowest average copay, and there are many different ways to save on the medication.
Pharmacy discount card programs like Pharmacists.org also offer savings on all FDA-approved brand name and generic medications, including Latuda, and patients can sign up for free.
What Are the Benefits of Latuda?
Latuda is a relatively new medication, having been introduced to the market in 2010. As an atypical antipsychotic, it offers a treatment option for patients suffering from bipolar depression, many of whom do not receive relief from their symptoms when taking antidepressants.
Bipolar depression is notoriously difficult to treat, and using standard antidepressants can cause unpleasant and unexpected side effects.
Most patients taking Latuda for either bipolar depression or schizophrenia start to notice that their symptoms improve within three to four weeks, and the medication is generally well tolerated.
What Warnings Are Associated With Latuda?
Latuda is associated with several warnings regarding its use. According to the medication guide, one of the most significant is the increased risk of death in elderly patients suffering from dementia-related psychosis.
Although people with dementia or Parkinson’s Disease may demonstrate symptoms of psychosis due to confusion and memory loss, they should not be treated with Latuda due to an increased risk of death.
Like other medications used for the treatment of depression, Latuda can increase the incidence of suicidal thoughts or behaviors in children, teenagers, and young adults in the first months of treatment or following a dosage change.
Patients and their caregivers should be aware of the increased risk of suicidal thoughts and behaviors and should monitor for new or worsening depression symptoms.
Sudden changes in mood, behaviors, thoughts, or feelings should be reported immediately to your healthcare professional.
Some patients develop a condition called tardive dyskinesia when taking antipsychotic medications for an extended period of time.
Tardive dyskinesia is defined by muscular movements that the patient is unable to control, such as grimacing, smacking of the lips, and sucking.
The condition can develop after taking Latuda for an extended period of time and may not subside if the medication is discontinued.
Patients may also demonstrate symptoms for the first time after they stop taking Latuda. All patients taking Latuda should have an Abnormal Involuntary Movement Scale (AIMS) completed regularly by their healthcare provider to monitor for tardive dyskinesia.
Additionally, schizophrenia is a serious mental health condition that requires continuous treatment. Patients should not stop taking Latuda even when they start to feel better, and it is important to avoid missed doses of the medication, as a relapse in symptoms may occur. Patients should not change their dose or stop taking their medication without the approval of their doctor.
What Dose of Latuda Should I Use?
The dose of Latuda that is prescribed to a patient depends on the patient’s age, condition to be treated, and medical history.
Regardless of their exact prescribing information, patients should always take Latuda with food (a meal of at least 350 calories) and store it at room temperature and protect from any hot weather.
Otherwise, the body will not absorb the appropriate amount of Latuda and therapeutic effects will be significantly reduced.
In general, adults diagnosed with schizophrenia receive an initial dose of 40 mg of Latuda taken once per day.
The maintenance dose is anywhere from 40 to 160 mg per day and should not exceed 160 mg per day.
Adolescents treated for schizophrenia take an initial dose of 40 mg once per day and may increase to a maintenance dose of between 40 and 80 mg per day based on medical advice from their doctor.
The maximum daily dosage is 80 mg per day.
Adults being treated for bipolar depression can expect to start on an initial dose of 20 mg taken once per day, while a maintenance dose is between 20 mg and 120 mg taken orally once per day.
The maximum dosage taken by adults for the treatment of bipolar depression is 120 mg per day.
Children and adolescents taking Latuda for treatment of bipolar depression will start with an initial dose of 20 mg taken once per day; the maintenance dose is anywhere from 20 mg to 80 mg taken once per day with a maximum dose of 80 mg per day. Contact a Poison Control Center immediately if excess amounts of Latuda are taken.
What Side Effects Are Associated With Latuda?
The list of side effects of Latuda depend on the age of the person taking the medication and the condition for which they are being treated. Side effects range from common to serious. Common side effects for adults with schizophrenia include:
- Sleepiness
- Drowsiness
- Restlessness and feeling the need to move around
- Difficulty moving
- Slow movements
- Muscle stiffness
- Nausea
Common side effects for adolescents between the ages of 13 and 17 being treated for schizophrenia include:
- Sleepiness
- Drowsiness
- Restlessness and feeling the need to move around (akathisia)
- Difficulty moving
- Slow movements
- Muscle stiffness
- Tremor
- Runny nose or nasal congestion
- Vomiting
Common side effects for adults with bipolar depression include:
- Sleepiness
- Drowsiness
- Restlessness and feeling the need to move around
- Difficulty moving
- Slow movements
Common side effects for children between the ages of 10 and 17 with bipolar depression include:
- Nausea
- Weight gain
- Insomnia
Serious side effects associated with Latuda that require immediate medical attention include:
- Stroke
- Neuroleptic malignant syndrome (NMS). Symptoms include:
- High fever
- Increased sweating
- Stiff muscles
- Confusion
- Changes in breathing, heart rate, or blood pressure
- Uncontrolled body movements called tardive dyskinesia
- High blood sugar, hyperglycemia, and diabetes
- Increased urination
- Increased levels of cholesterol and triglycerides
- Weight gain
- Increased prolactin levels in the blood
- Low white blood cell count
- Low blood pressure
- Feeling light-headed when rising too quickly from a sitting or lying position
- Falls resulting from sleepiness, dizziness, or low blood pressure
- Seizures
- Difficulty controlling body temperatures
- Mania or hypomania in people with bipolar disorder
- Difficulty swallowing
Can Women Who Are Pregnant or Breastfeeding Use Latuda?
Women who are pregnant or planning to become pregnant and are taking Latuda should speak to their doctors about using the medication.
Untreated schizophrenia and bipolar depression can have serious risks for both the mother and the fetus, and there may be situations in which the benefits of taking Latuda outweigh the risk factors of using the medication during pregnancy. It should be noted that the use of antipsychotic medications like Latuda in the third trimester of pregnancy increases the risk for abnormal muscle movements called extrapyramidal symptoms and can also increase the risk of withdrawal symptoms in newborn infants after delivery.
Withdrawal symptoms may include agitation, hypertonia, hypotonia, somnolence, tremor, respiratory distress, and feeding disorder. It is currently unknown if Latuda passes through breast milk, so women who are nursing or planning on nursing their babies should talk to their doctors about using Latuda.
Do Any Other Drugs Interact With Latuda?
These medications include Cardizem (diltiazem), Ery-tab (erythromycin), and fluconazole (Diflucan). Grapefruit juice has also been found to increase levels of Latuda in the bloodstream.
Blood tests have found that other medications may decrease the levels of Latuda in the bloodstream and reduce its effects, including Tegretol (carbamazepine) and phenobarbital.
Make sure you tell your doctor about all of the medications you are taking, including prescription drugs, over the counter medications like antihistamines, vitamins, supplements, and any herbs you may use, like St. John’s Wort.
There are numerous possible drug interactions that can affect the level of Latuda in your system, so it’s important to give your doctor a complete medication list.
References, Studies and Sources:
https://www.drugs.com/latuda.html
https://www.nami.org/NAMI/media/NAMI-Media/Infographics/NAMI-You-Are-Not-Alone-FINAL.pdf
