Identification of clinical phenotypes in schizophrenia: the role of lurasidone

Abstract

The treatment of schizophrenia includes the control of symptoms, the prevention of relapses, and amelioration of adaptive skills for patient re-integration into society. Antipsychotic drugs are the agents of choice for the treatment of schizophrenia, as they reduce the positive symptoms of psychosis. Lurasidone is a second-generation antipsychotic drug representing a novel and useful clinical tool for the management of schizophrenia. A board consisting of a panel of Italian expert psychiatrists was organized with the following aims: (a) defining the current modalities of use of lurasidone, highlighted through 17 specific questions; (b) defining and agreeing the main features of the drug and the principal reasons to suggest its administration. We established that lurasidone is suggested at any age, with no gender difference, at all stages of the disease. The switch from previous treatments is done primarily because of lack of efficacy as well as poor adherence/tolerability. Lurasidone is among the best-tolerated antipsychotics, and its use is indicated in the presence of different comorbidities. A wide range of dosages is available, allowing safe titration in particular cases, with the highest dose (148 mg) generally used for the treatment of the acute phase. The discontinuation rate due to poor tolerability, low compliance, and interactions with other drugs is very low. Akathisia is the most reported adverse event, but it may be controlled by dose reduction. Lurasidone does not possess a marked sedative action but, in agitated patients, can be associated with sedative drugs, such as benzodiazepines. The most frequent reason for switching to other therapies is the need for long-acting formulations, as in patients at risk of very low adherence or suicide. Lurasidone does not strongly impact metabolism or the cardiovascular system (QT interval), and does not influence the metabolism of other drugs, showing good efficacy and tolerability.

The role of lumateperone in the treatment of schizophrenia

“…101–103 PET will provide a tool to identify the effects of lumateperone on neurotransmitter systems already studied 21,46 and other possible pathways. 92,100 Comprehensive multi-modal investigations by teams of experts around the world will facilitate the identification of biomarkers for clinical phenotypes of schizophrenia 104 to provide clinicians with the foundations to apply precision medicine to individuals with schizophrenia.…”

Lurasidone for the treatment of schizophrenia in adult and paediatric populations

“…In addition, the increase in prolactin is slightly and significantly lower compared with risperidone. 69 , 71 , 72 …”

“…The effect on the 5HT 7 receptor, together with the partial agonism of 5HT 1A , could translate into an improvement at the level of memory, learning, motivation and cognition as well as recovery at the level of affective and negative symptoms, meaning an improvement in quality of life and functional recovery of patients. [69][70][71] Lurasidone has been included amongst the antipsychotics with lower metabolic risk, improving the weight gain associated with other antipsychotic treatments. In addition, the increase in prolactin is slightly and significantly lower compared with risperidone.…”

Adherence to Typical Antipsychotics among Patients with Schizophrenia in Uganda: A Cross-Sectional Study

“…Schizophrenia is a multidimensional disorder with several subtypes, different neurobiological underpinnings, and several lines of treatment to control the symptoms-mainly antipsychotics [1][2][3]. However, over the past years, a lack of adherence to antipsychotic drugs has emerged as one of the clinicians' biggest challenges in treating and managing schizophrenia patients [4,5].…”