It is not entirely known how Latuda works, but it is thought to block the action of a chemical messenger in the brain called dopamine. Dopamine signals are characteristically abnormal in people with schizophrenia and bipolar disorder.
Latuda is available as an oral tablet. There are no generic versions of Latuda yet available.
What Is Latuda Used For?
The Food and Drug Administration (FDA) first approved Latuda to treat schizophrenia in 2010. In 2013, the FDA expanded its approval to include bipolar I disorder, considered the more severe form of bipolar disorder.
Brand Name(s): Latuda
Administration Route(s): Oral
Drug Availability: Prescription
Therapeutic Classification: Antipsychotic
Available Generically: No
Controlled Substance: N/A
Active Ingredient: Lurisadone
Dosage Form(s): Tablet
Latuda works by rebalancing dopamine in your body so that you can think more clearly. With schizophrenia, Latuda helps alleviate both “positive symptoms” (such as hallucinations and delusions) and “negative symptoms” (such as emotional blunting and the lack of motivation). With bipolar disorder, the drug helps alleviate episodes of depression.
The FDA has approved Latuda to treat:
Schizophrenia in adults and children 13 to 17 years old Depressive episodes of bipolar I disorder in adults and children aged 10 to 17 years when used on its own (i. e. , monotherapy) Depressive episodes of bipolar I disorder in adults when used in combination with lithium or valproate
Unlike other atypical antipsychotics, Latuda has not proven effective in treating manic episodes of bipolar I disorder and is not used for such.
How to Take Latuda
Latuda is taken by mouth and available as an oral tablet in five different strengths:
20 milligrams (mg)40 mg60 mg80 mg120 mg
Your prescribed dose will depend on your age and treated condition.
Latuda is taken once daily with a meal containing at least 350 calories. Taking Latuda with a meal increases its peak concentration in the blood by threefold and its therapeutic concentration (the level at which the drug is active) by twofold.
Latuda tablets need to be swallowed whole. Do not crush, chew, or split the tablets, as this can affect drug absorption.
Storage
Latuda tablets can be safely stored at room temperature (around 77 F). It is OK to expose the tablets to temperatures between 59 F and 86 F, but avoid storing them on a sunny windowsill or in a glove compartment where temperature can be excessive.
Keep the tablets in their original light-resistant container. Discard any drugs that have expired.
Off-Label Uses
Healthcare providers sometimes prescribe Latuda off-label to treat psychosis related to major depressive disorder (MDD) or agitation associated with dementia. Off-label use means that it can be prescribed for other medical conditions that it is not approved to treat.
A small study from 2017 found that people with MDD who took a six-week course of Latuda experienced significant reductions in symptoms of depression and anxiety.
The evidence supporting the use of atypical antipsychotics in treating dementia is limited, with most studies suggesting only a modest benefit. The drugs are usually only considered if the symptoms are severe and other strategies have failed to provide relief.
What Are the Side Effects of Latuda?
This is not a complete list of side effects and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA atwww.fda.gov/medwatch or 1-800-FDA-1088.
The drug reaches a steady state concentration in the body within seven days.
As with all drugs, Latuda may cause side effects. Those associated with Latuda are similar to those of other atypical antipsychotics. Some side effects are immediate and may gradually resolve as your body adapts to treatment. Others may be the result of long-term use and, in rare instances, cause permanent neurological problems.
Let your healthcare provider know if side effects are unusual, worsening, or intolerable so that the treatment can be adjusted if needed. Never stop taking Latuda without speaking with your provider.
Common Side Effects
The common side effects of Latuda mainly involve the gastrointestinal tract and nervous system.
Common side effects include:
Nausea Daytime sleepiness Restlessness Anxiety Dry mouth Diarrhea Vomiting Fatigue Increased appetite (mainly with bipolar disorder) Weight gain (mainly with bipolar disorder) Viral infections (mainly in children) Urinary tract infections
Dizziness or fainting may also occur due to a sudden drop in blood pressure (orthostatic hypotension), particularly when first starting treatment.
Weight gain, a common concern with all antipsychotic drugs, is linked to blood sugar and cholesterol increases. Even so, this appears to be less of a problem with Latuda than with other atypical antipsychotics.
The risk of side effects is dose-dependent, meaning that higher doses lead to a greater likelihood of side effects.
Severe Side Effects
This medication carries two boxed warnings. A boxed warning is the highest level of warning issued by the FDA.
The FDA advises caution when using Latuda in older adults (aged 65 years and older) with dementia-related psychosis due to the risk of heart-related death. and children and young adults. Latuda can also increase the risk of suicidal thoughts in children and young adults
Because of its effect on blood sugar, Latuda can make diabetes harder to control and, in some cases, cause type 2 diabetes. While the risk is relatively low, studies have shown that Latuda can cause or increase glucose intolerance.
Latuda can also increase levels of a hormone called prolactin that stimulates the production of breast milk. Abnormally high prolactin levels called hyperprolactinemia can lead to irregular periods and reduced fertility in females, and reduced sex drive, low sperm counts, and enlarged breasts in males.
Another rare complication of Latuda use is neuroleptic malignant syndrome (NMS). NMS is a severe reaction to antipsychotic drugs that affects the nervous system, causing muscle stiffness, rapid or irregular heartbeat, and severe changes in blood pressure. If left untreated, NMS can be life-threatening. Most cases develop within the first two weeks of treatment.
Call your healthcare provider right away if you have serious side effects after using Latuda. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. These include symptoms of NMS, such as:
TremorsMuscle crampsHigh feverAgitationDisorientationDizziness or faintingIncreased heart rateRapid breathingProfuse sweatingSkin flushingIncontinenceUnusual physical movements
If left untreated, NMS can lead to acute kidney failure, coma, and death.
Long-Term Side Effects
Long-term Latuda use is common, particularly for people with schizophrenia. Side effects associated with the ongoing use of Latuda are often more profound and, in some cases, can cause irreversible harm.
Tardive dyskinesia (TD), a neurological disorder, is associated with the long-term use of certain psychiatric drugs. TD causes uncontrollable facial or body movements such as:
Lip smackingTongue thrustingGrimacingMouth puckeringUnusual arm or leg movements
The onset of symptoms can vary, with some people developing TD within the first six months of treatment, while others only experience symptoms after a year or more of use. Because TD is often permanent, you may need to stop taking Latuda if symptoms develop.
With that said, not everyone taking Latuda will develop TD. TD is still regarded as a relatively uncommon condition among Latuda users.
Dosage: How Much Latuda Should I Take?
Modifications
If you have kidney or liver disease, your healthcare provider may need to adjust your dose of Latuda. Your dose may be modified as follows:
If you experience a serious side effect, you or your provider may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
For oral dosage form (tablets): For schizophrenia: Adults—At first, 40 milligrams (mg) once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 160 mg per day. Children 13 to 17 years of age—At first, 40 milligrams (mg) once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 80 mg per day. Children younger than 13 years of age—Use and dose must be determined by your doctor. For depression: Adults—At first, 20 milligrams (mg) once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 120 mg per day. Children 10 to 17 years of age—At first, 20 milligrams (mg) once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 80 mg per day. Children younger than 10 years of age—Use and dose must be determined by your doctor.
Kidney disease: Starting dose may be reduced to 20 mg per day, increasing to a maximum of no more than 80 mg per day for people with a creatinine clearance of less than 50 milliliters per minute (mL/min). Liver disease: Starting dose may be reduced to 20 mg per day, increasing to a maximum of no more than 80 mg per day in people with moderate liver impairment (Child-Pugh score 7 to 9) and a maximum of no more than 40 mg per day in people with severe liver impairment (Child-Pugh score 10 to 15).
You may also need to undergo kidney functions tests and liver function tests routinely performed treatment to ensure drug safety.
Missed Dose
If you miss a dose of Latuda, take it as soon as you remember. If it is almost time for your next dose, skip the initial dose and continue as normal. Never double up doses.
As with all chronic psychiatric drugs, consistent dosing is needed to maintain the optimal drug concentrations in the body. If you have trouble taking your medications or regularly miss doses, speak with your healthcare provider, who can help.
Overdose: What Happens If I Take Too Much Latuda?
There is limited research regarding the hazards of a Latuda overdose. During previous studies, one person overdosed on 560 mg of Latuda—seven times the maximum daily dose—and recovered without any consequence.
This should not suggest that the risk of overdose is low. No one knows for sure at what dose Latuda can become deadly.
Taking too much Latuda can cause:
A dangerous drop in blood pressure Severe heart rhythm problems Seizures Extrapyramidal effects (such as involuntary muscle contractions and rigidity)
Anyone who overdoses on Latuda should seek medical care for an immediate evaluation. In some cases, you might need to undergo gastric lavage (“stomach pumping”) along with a laxative and activated charcoal treatment to help in getting the drug out of the body. Beyond these interventions, there are no specific antidotes for a Latuda overdose.
Always keep medications out of the reach of children or pets to avoid an accidental overdose.
Precautions
What Are Reasons I Shouldn’t Take Latuda?
There are several instances in which Latuda may not be the right treatment for you. Your healthcare provider will help determine whether it is safe for you to take this medication.
If someone collapses or isn’t breathing after taking Latuda, call 911 immediately.
Lurasidone should not be used with certain medicines such as carbamazepine (Tegretol®), clarithromycin (Biaxin®), ketoconazole (Nizoral®), phenytoin (Dilantin®), rifampin (Rifadin®, Rimactane®), ritonavir (Norvir®), St. John’s wort, or voriconazole (Vfend®). Using these medicines together may cause serious unwanted effects. Make sure your doctor knows all of the medicines you are taking.
Lurasidone may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies. If you or your caregiver notice any of these side effects, tell your doctor right away.
This medicine may increase risk of transient ischemic attack or stroke in elderly patients. Tell your doctor right away if you have confusion, double vision, headache, inability to move the arms, legs, or facial muscles, slow speech, or trouble speaking, thinking, or walking while using this medicine.
Check with your doctor right away if you have any of the following symptoms while using this medicine: convulsions (seizures), difficulty with breathing, a fast heartbeat, a high fever, high or low blood pressure, increased sweating, loss of bladder control, severe muscle stiffness, unusually pale skin, or tiredness. These could be symptoms of a serious condition called neuroleptic malignant syndrome (NMS).
This medicine may cause tardive dyskinesia (a movement disorder). Check with your doctor right away if you have lip smacking or puckering, puffing of the cheeks, rapid or worm-like movements of the tongue, uncontrolled chewing movements, or uncontrolled movements of the arms and legs while you are using this medicine.
This medicine may increase the amount of sugar in your blood. Check with your doctor right away if you have increased thirst or increased urination. If you have diabetes, you may notice a change in the results of your urine or blood sugar tests. If you have any questions, check with your doctor.
This medicine may increase your weight. Your doctor may need to check your weight on a regular basis while you are using this medicine. Talk to your doctor about ways to prevent weight gain.
Lurasidone can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. If you can, avoid people with infections. Check with your doctor right away if you think you are getting an infection, or if you have a fever or chills, a cough or hoarseness, lower back or side pain, or painful or difficult urination.
Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position. Getting up slowly may help. If the problem continues or gets worse, check with your doctor.
This medicine may cause some people to become drowsy or dizzy, or to have trouble with thinking or controlling body movements, which may lead to falls, fractures or other injuries. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
Avoid activities involving high temperature or humidity. This medicine may reduce your body’s ability to adjust to the heat.
This medicine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for allergies or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicines including other narcotics, medicine for seizures (eg, barbiturates), muscle relaxants, or anesthetics (numbing medicines), including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine.
Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Allergy
Latuda should never be used in anyone with a known allergy or hypersensitivity to lurasidone or any of the other ingredients in Latuda.
Boxed Warnings
Latuda also carries two black box warnings. Black box warnings are the highest level of warning issued by the FDA regarding a drug’s potential hazards.
With regards to Latuda, the FDA advises caution when using Latuda in the following groups:
Adults over the age of 65 years with dementia-related psychosis: The use of antipsychotic drugs in this group almost doubles the risk of death, typically from a cardiovascular event (like heart failure or sudden death) or an infection (such as aspiration pneumonia). Children and young adults: Any drug used to treat depression can trigger suicidal thoughts or behaviors in younger people.
Pregnancy and Breastfeeding
Animal studies have shown a potential for fetal harm with Latuda, but there are no proven risks in humans. Even so, studies have shown that the use of antipsychotic drugs in the third trimester can lead to drug withdrawal and neurological effects in newborns. It is unknown if people who are breastfeeding can pass Latuda to the infant through breast milk.
If pregnant or planning to get pregnant, speak with your healthcare provider to understand the benefits and potential risks of Latuda fully. The same applies to the use of Latuda while breastfeeding.
What Other Medications Interact With Latuda?
Latuda relies on a liver enzyme called cytochrome P450 3A4 (CYP3A4) for metabolization in the body. Metabolization is when a drug is broken down to leave the body at an expected rate.
Any change in this process can either decrease the amount of Latuda in the bloodstream (reducing its efficacy) or increase the amount of Latuda in the bloodstream (increasing the risk of side effects).
Because of this, Latuda should not be used with strong CYP3A4 inducers (that increase the enzyme activity) or potent CYP3A4 inhibitors (that decrease the enzyme activity).
The shortlist of these drugs includes:
Biaxin (clarithromycin) Dilantin (phenytoin) Nizoral (ketoconazole) Norvir (ritonavir) Rifadin, Rimactane (rifampin) St. John’s wort Tegretol (carbamazepine) Vfend (voriconazole)
Your healthcare provider may need to increase your dose if you are using Latuda with a moderate CYP3A4 inducer (like dexamethasone). If Latuda is used with a moderate CYP3A4 inhibitor (like erythromycin or fluconazole), the starting dose should be reduced to 20 mg per day and increased to no more than 80 mg per day.
To avoid interactions, always advise your healthcare provider about any drugs you take, whether prescription, over-the-counter, herbal, nutritional, or recreational.
What Medications Are Similar?
There are nine other atypical antipsychotics approved by the FDA, as well as one drug combining an atypical antipsychotic and an antidepressant:
Abilify (aripiprazole)Clozaril (clozapine)Fanapt (iloperidone)Geodon (ziprasidone)Invega (paliperidone)Risperdal (risperidone)Saphris (asenapine)Seroquel (quetiapine)Symbyax (olanzapine/fluoxetine)Zyprexa (olanzapine)
Latuda has some advantages and disadvantages over these drugs. Among them, Latuda has a generally lower risk of metabolic side effects (e.g., obesity and diabetes), neurocognitive side effects (e.g., sedation), and hyperprolactinemia.
On the downside, Latuda has a higher risk of affecting extrapyramidal function than some other drug options (but less than typical, also known as conventional, antipsychotics). Extrapyramidal function refers to motor control and coordination. Latuda also cannot be used in the treatment of bipolar mania.
How Can I Stay Healthy While Taking Latuda?
Latuda can be highly effective in alleviating symptoms of schizophrenia and bipolar disorder if used as prescribed. Make sure you take the drug every day with a full meal to ensure ample absorption. You also need to see your healthcare provider regularly to manage and avoid side effects and complications.
You can further amplify the benefits of treatment by maintaining good physical and mental health practices. According to the National Alliance of Mental Illness (NAMI), this includes:
Seeking support and maintaining connections: Reach out to friends and families, and seek support groups through your therapist, psychiatrist, social worker, or church. Managing stress: Stress can trigger psychosis in people with schizophrenia and anxiety in people with bipolar depression. Routine exercise and getting outdoors can help manage stress, as can mind-body therapies such as yoga and meditation. Getting plenty of sleep: Insomnia and irregular sleep patterns are common in schizophrenia and bipolar depression. To get yourself back on a regular sleep schedule, avoid excessive daytime sleep and adhere to sleep hygiene practices (including routine bedtimes and avoiding food and electronics before sleep). Avoiding alcohol and drugs: Some people with schizophrenia and bipolar disorder turn to drugs and alcohol to deal with anxiety and depression. Doing so can have an opposite effect, triggering psychosis or leading to even deeper depression. If you have an alcohol or substance abuse problem, don’t be silent; speak with your doctor about treatment options appropriate to your condition.
If unable to cope, do not hesitate to reach out for help. Call the NAMI HelpLine at 1-800-950-NAMI (6264), available Monday through Friday, 10:00 a.m. to 10:00 p.m. Eastern time.
