Critical appraisal of lurasidone in the management of schizophrenia

Silvio Caccia, Luca Pasina, Alessandro NobiliIstituto di Ricerche Farmacologiche, &ldquo;Mario Negri&rdquo;, Milan, ItalyAbstract: Lurasidone is a new atypical antipsychotic in the benzoisothiazoles class of chemicals. Like most second-generation antipsychotics it is a full antagonis...

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Autores principales:	Caccia S, Pasina L, Nobili A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/96d715a4b74646e18bf4a8fb4ce307f5
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spelling	oai:doaj.org-article:96d715a4b74646e18bf4a8fb4ce307f52021-12-02T04:13:26ZCritical appraisal of lurasidone in the management of schizophrenia1176-63281178-2021https://doaj.org/article/96d715a4b74646e18bf4a8fb4ce307f52012-04-01T00:00:00Zhttp://www.dovepress.com/critical-appraisal-of-lurasidone-in-the-management-of-schizophrenia-a9722https://doaj.org/toc/1176-6328https://doaj.org/toc/1178-2021Silvio Caccia, Luca Pasina, Alessandro NobiliIstituto di Ricerche Farmacologiche, &ldquo;Mario Negri&rdquo;, Milan, ItalyAbstract: Lurasidone is a new atypical antipsychotic in the benzoisothiazoles class of chemicals. Like most second-generation antipsychotics it is a full antagonist at dopamine D2 and serotonin 5-HT2A receptors, and is a partial agonist at 5-HT1A receptors, a property shared by some but not all older agents. It has much greater affinity for 5-HT7 subtype receptors than other atypical antipsychotics. Pharmacokinetic studies showed that lurasidone is reasonably rapidly absorbed, with bioavailability appearing to be increased by food. Lurasidone undergoes extensive metabolism to a number of metabolites, some of which retain pharmacological activities. Metabolism is mainly by CYP3A4, resulting in steady-state concentrations that vary between individuals and are potentially affected by strong inducers and inhibitors of this enzyme. Short-term clinical trials have demonstrated the efficacy of lurasidone in acute schizophrenia, with doses of 40 and 80 mg/day giving significant improvements from baseline in the PANSS and BPRS scores. The most common adverse events are nausea, vomiting, akathisia, dizziness, and sedation, with minimal increases in the risk of developing metabolic syndrome. Lurasidone did not raise the risk of QTc interval prolongation, although additional studies are required. Long-term trials are also needed to assess the risk of new-onset diabetes. Ongoing trials in patients with bipolar disorder are being completed but, again, efficacy and safety have been investigated only in a few short-term clinical trials.Keywords: lurasidone, pharmacology, pharmacokinetics, efficacy, safetyCaccia SPasina LNobili ADove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2012, Iss default, Pp 155-168 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Caccia S Pasina L Nobili A Critical appraisal of lurasidone in the management of schizophrenia
description	Silvio Caccia, Luca Pasina, Alessandro NobiliIstituto di Ricerche Farmacologiche, &ldquo;Mario Negri&rdquo;, Milan, ItalyAbstract: Lurasidone is a new atypical antipsychotic in the benzoisothiazoles class of chemicals. Like most second-generation antipsychotics it is a full antagonist at dopamine D2 and serotonin 5-HT2A receptors, and is a partial agonist at 5-HT1A receptors, a property shared by some but not all older agents. It has much greater affinity for 5-HT7 subtype receptors than other atypical antipsychotics. Pharmacokinetic studies showed that lurasidone is reasonably rapidly absorbed, with bioavailability appearing to be increased by food. Lurasidone undergoes extensive metabolism to a number of metabolites, some of which retain pharmacological activities. Metabolism is mainly by CYP3A4, resulting in steady-state concentrations that vary between individuals and are potentially affected by strong inducers and inhibitors of this enzyme. Short-term clinical trials have demonstrated the efficacy of lurasidone in acute schizophrenia, with doses of 40 and 80 mg/day giving significant improvements from baseline in the PANSS and BPRS scores. The most common adverse events are nausea, vomiting, akathisia, dizziness, and sedation, with minimal increases in the risk of developing metabolic syndrome. Lurasidone did not raise the risk of QTc interval prolongation, although additional studies are required. Long-term trials are also needed to assess the risk of new-onset diabetes. Ongoing trials in patients with bipolar disorder are being completed but, again, efficacy and safety have been investigated only in a few short-term clinical trials.Keywords: lurasidone, pharmacology, pharmacokinetics, efficacy, safety
format	article
author	Caccia S Pasina L Nobili A
author_facet	Caccia S Pasina L Nobili A
author_sort	Caccia S
title	Critical appraisal of lurasidone in the management of schizophrenia
title_short	Critical appraisal of lurasidone in the management of schizophrenia
title_full	Critical appraisal of lurasidone in the management of schizophrenia
title_fullStr	Critical appraisal of lurasidone in the management of schizophrenia
title_full_unstemmed	Critical appraisal of lurasidone in the management of schizophrenia
title_sort	critical appraisal of lurasidone in the management of schizophrenia
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/96d715a4b74646e18bf4a8fb4ce307f5
work_keys_str_mv	AT caccias criticalappraisaloflurasidoneinthemanagementofschizophrenia AT pasinal criticalappraisaloflurasidoneinthemanagementofschizophrenia AT nobilia criticalappraisaloflurasidoneinthemanagementofschizophrenia
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Critical appraisal of lurasidone in the management of schizophrenia

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