Latuda for adhd
The Dopamine Dilemma - PMC
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How Lurasidone Works For ADHD, Anxiety, and Other Mental Disorders
How Lurasidone Works For ADHD, Anxiety, and Other Mental Disorders
- Post author:MedicaPharma Team
- Post published:June 27, 2022
- Post category:Product Guide
Lurasidone, also known as lurasidone hydrochloride, is a prescription drug administered for numerous mental disorders, including anxiety, bipolar disease, depression, sleep disorders, and schizophrenia.
Sold under the brand name Latuda, lurasidone is available in the US, Canada, Switzerland, Denmark, Norway, the U. K., the Netherlands, Finland, Australia, Sweden, Thailand, Hong Kong, and Singapore. The drug is also available in India under numerous brand names, including Lurasid, Alsiva, Emsidon, Lurakem, Luratrend, Tablura, Lurastar, Atlura, Lurace, Lurafic, Luramax, Latuda, Lurata, and Unison.
Table of Contents
What is Lurasidone?
Sold under numerous brand names worldwide, Lurasidone is an antipsychotic drug prescribed and administered for various mental disorders, including anxiety, depression, bipolar, schizophrenia, and sleep disorders. For bipolar conditions, it is typically prescribed along with a mood-stabilizing drug such as valproate or lithium.
Lurasidone Regulatory ApprovalUnited States
FDA approval of lurasidone in the US is indicated for the treatment of:
- Schizophrenia in adults and children/adolescents aged 13-17 years
- Depression with bipolar disorder in adults and children aged 10-17 years
- Depression associated with bipolar disorder in adults, in combination with valproate or lithium
Lurasidone is approved in the EU to treat schizophrenia in adults aged 18 years and over. The drug is not approved for bipolar disorder.
Researchers are unclear on Lurasidone’s mechanism of action, however it is believed to have an effect on the production of serotonin and dopamine in the brain.Pharmacodynamics
Lurasidone acts as a brain receptor antagonist of the dopamine receptors (D2 and D3), α2C-adrenergic receptor, and serotonin 5-HT2A and 5-HT7 receptors. The drug is also a partial agonist of the serotonin 5-HT1A receptor.
Studies suggest that lurasidone has a low and likely clinical affinity for serotonin 5-HT2C receptors. According to research, this may explain the drug’s low propensity to stimulate appetite and affect weight gain. In addition, the drug also has negligible affinity for muscarinic acetylcholine receptors and histamine h2 receptors and therefore has no anticholinergic effects or antihistamine effects.Pharmacokinetics
The main active metabolite in Lurasidone is ID-14283 and norbornane ring hydroxylation is highlighted. Lurasidone’s other active metabolite is ID-14326, and it has the OH group in the endo position. Metabolites ID-11614 and ID-20219 are produced via the main inactivation step by oxidative N-dealkylation.
When taken by mouth, Lurasidone has an estimated 9-19% absorption rate. Researchers found that absorption increases approximately twofold when lurasidone is taken with food and peak blood plasma concentrations are reached after 1-3 hours. Approximately 99% of the circulating substance is bound to plasma proteins.
Lurasidone is predominantly metabolized via the enzyme CYP3A4 in the liver. The drug has a minimal affinity to other P450 cytochrome enzymes. It is transported by ABCG2 and P-glycoprotein, and additionally inhibits these carrier proteins in vitro while inhibiting solute carrier protein SLC22A1 without other relevant transporters.
The biological half-life of Lurasidone is 18 hours and 20-40 hours depending on the source. Nine to 19% is recovered from the urine, and 80% or 67% (of a radiolabelled dose) is recovered from the feces.
Lurasidone doses depend on the condition being treated. Some lurasidone treatment dosages include:Lurasidone for Anxiety
There is no standard lurasidone for anxiety. The average prescription according to online sources is 20-120 mg per day.Lurasidone for Bipolar Depression
- Monotherapy: 20 mg per day not to exceed 120 mg/day
- Adjunctive therapy: 20 mg per day not to exceed 120 mg/day
- Monotherapy: 20 mg per day not to exceed 120 mg/day
- Adjunctive therapy: 20 mg per day not to exceed 120 mg/day
- 40 mg per day initially, not to exceed 160 mg/day
Lurasidone vs. Risperidone
Risperdal (risperidone) is thought to help control thoughts and mood while lurasidone (Latuda) is indicated for depression and schizophrenia-related to bipolar disorder.Lurasidone for Sleep Disorders
According to one study, lurasidone increased total sleep time by an average of 28.4 minutes in the laboratory when compared to a placebo. In addition, the drug was found to decrease wake time after sleep onset, and after the final awakening. Researchers also believe it increases sleep efficiency.Lurasidone for PTSD
Lurasidone is rarely prescribed for PTSD. However a randomized, double-blind study by Monelly, et al. suggests that 0.5 to 2mg of the alternative risperidone reduces intrusive thoughts and irritability in combat-related PTSD.
Lurasidone Side Effects
Latuda/Lurasidone side effects include:
- Weight gain
- Lipid-related adverse effects
- Increased risk for a stroke
- Increased risk of transient ischemic attack
- Increased mortality
- Mask-like facial expressions
- Inability to keep still
Lurasidone may cause facial muscle twitching in addition to tardive dyskinesia – a condition characterized by uncontrollable movements such as mouth puckering, lip-smacking, tongue thrusting, mouth chewing, and other unusual arm and leg movements.
This condition may be permanent in some cases.Lurasidone Interactions
Lurasidone increases blood plasma concentrations when used with CYP3A4 inhibitors. This may lead to additional side effects, and has been verified for ketoconazole and other 3A4 inhibitors such as grapefruit juice.
Frequently asked questions:
How does lurasidone work?
Lurasidone works by antagonizing specific receptors in the brain. Research suggests that the drug acts as an antagonist of the α2C-adrenergic receptor, dopamine receptors (D3 and D2), and serotonin 5-HT2A and 5-HT7 receptors. In addition, it is also a partial agonist of the serotonin 5-HT1A receptor.
What is lurasidone used for?
Lurasidone or lurasidone hydrochloride is an atypical antipsychotic prescribed to treat several mental illnesses and disorders such as anxiety, sleep disorders, bipolar, depression, schizophrenia, and post-traumatic stress disorder.
What drug class does lurasidone belong to?
Lurasidone belongs to a class of medications called atypical antipsychotics. Atypical antipsychotics work by altering the activity of certain substances or hormones in the brain responsible for mood, such as dopamine and serotonin.
How does lurasidone affect dopamine and serotonin?
Lurasidone works by acting as an antagonist of the dopamine receptors (D3 and D2), α2C-adrenergic receptor, and serotonin 5-HT2A and 5-HT7 receptors. The drug also acts on the serotonin 5-HT1A receptor as a partial antagonist.
How long does it take for lurasidone to work?
Lurasidone (or Latuda) results vary substantially between patients depending on their height, weight, and the condition being treated. Generally, the drug works for most patients within 6 weeks and possibly sooner depending on the dose.
Special Active Pharmaceutical Ingredients (GMP)
Full GMP API Product List
Latuda - indications, analogs, reviews
Brief information about the drug
The active ingredient of the drug is lurasidone. In 2010, the FDA approved this substance. In our country, Latuda was patented in 2006.
Lurasidone has affinity for receptors:
- 5-HT7- and 5-HT1a-serotonin
- 5-HT2A- and D2-dopamine
- α2a- and α2c-adrenergic
At the same time, the substance does not bind to muscarinic and histamine receptors.
The drug is available in the form of tablets for oral administration.
Use: when to prescribe
Clinical studies have shown the effectiveness of the drug in:
- Schizophrenia (a mental disorder characterized by the breakdown of thought processes and emotional reactions)
- Depressive episodes in bipolar I disorder (mental pathology in which phases of mania alternate with phases of depression)
The drug is not prescribed for patients under 18 years of age, as well as for:
- Simultaneous therapy with strong inducers of the CYP3A4 isoenzyme (including phenobarbital), strong inhibitors of the CYP3A4 isoenzyme (including ketoconazole, saquinavir), perforated, rifampicin
- Pregnancy and lactation
- Individual intolerance to the components of the drug
There are diseases in which the use of Latuda requires special care. For example, cardiovascular pathologies, Parkinson's disease, kidney and liver failure, seizures, etc.
Antipsychotics increase mortality in older people with dementia, according to some studies. The use of lurasidone in this category of patients has not been studied.
Most common adverse reactions:
- Restlessness, anxiety
- Sleep problems
- Nausea and vomiting
- Stomach discomfort, upper abdominal pain
- Weight increase
- Excessive salivation or dry mouth
- Agitation (restlessness, which is usually accompanied by strong emotional arousal, anxiety and fear)
- Akathisia (internal restlessness, which is manifested by the inability to remain in one position)
- Parkinsonism (neurological syndrome, in which there is hypertonicity of the muscles, slowness of movement, trembling of the limbs at rest)
- Increased skeletal muscle tone
- Dystonia (abnormal contractions of muscle groups)
- Increased blood levels of creatine phosphokinase and creatinine
Infrequently and rarely, the following side effects may occur:
- Pain in the muscles, back and neck
- Pressure increase or decrease
- "Hot flashes" (feeling of intense warmth over the upper body and face)
- Nasopharyngitis (inflammation of the mucous membranes of the nose and throat)
- Catatonia (syndrome, the main manifestation of which is a movement disorder - stupor or agitation)
- Decreased appetite
- Flatulence (gas formation)
- Lethargy (painful condition similar to prolonged sleep)
- Dysarthria (distortion, difficulty pronouncing certain sounds or words)
- Excessive sweating
- Blurred vision
- Increase in heart rate or, conversely, slow heart rate
- Malignant neuroleptic syndrome (fever, muscle hypertonicity, impaired consciousness, instability of autonomic functions (respiration, digestion, heartbeat, bladder function, etc. ), increased activity of creatine phosphokinase in the blood)
- Anemia (decrease in red blood cells and hemoglobin)
- Leukopenia (decrease in the number of leukocytes)
- Neutropenia (decreased content of a special type of white blood cells - neutrophils)
- Increased blood sugar
- Sodium reduction
- Increase in alanine aminotransferase
- Panic attacks (severe attacks of anxiety accompanied by increased heart rate, respiratory failure and other autonomic manifestations)
- Suicidal behavior
- Joint stiffness
- Urinary disorders
- Erectile dysfunction
- Missing periods or painful periods
- Rhabdomyolysis (destruction of muscle tissue, which is also accompanied by kidney failure)
- Dysphagia (swallowing disorder)
- Gastritis (inflammatory or inflammatory-dystrophic changes in the gastric mucosa)
- Allergic reactions
- Renal failure
- Breast pain
- Extrapyramidal disorders (tremor, rigidity, mask-like face, gait and posture disturbances, dystonia, excessive salivation)
Latuda is the only officially registered drug in Russia containing lurasidone as an active ingredient.
Only a doctor can select another antipsychotic after a thorough diagnosis of the patient.
Latuda and alcohol
Simultaneous use of the drug with alcohol is unacceptable - both substances affect the central nervous system, so the consequences are unpredictable.
Latuda and transport
The drug has little effect on the ability to drive a car. But if it is not reliably confirmed that the patient has no adverse reactions, the doctor should warn him about the dangers of driving a car and working with other mechanisms.
As a rule, people who are prescribed the drug do not have a driver's license for medical reasons.
Is Latuda addictive?
At the same time, there are no systematic studies that would reliably refute such a possibility. Therefore, patients with a history of addiction require particularly careful medical supervision during treatment with lurasidone.
ReviewsSource: https://ru.braggcreekanihosp.com/65695-latudal-81 80%D0%B0%D0%B7%D0%B8%D0%B4%D0%BE%D0%BD-%D0%BB%D0%B0%D1%82%D1%83%D0%B4%D0%B0 /
Source: https://psy-ru. org/viewtopic.php?f=31&t=6325
Answers to frequently asked questions
Why can't I drink grapefruit juice while taking the drug?
According to the official instructions, grapefruit juice increases blood levels of lurasidone. Therefore, during therapy it is recommended not to consume this food product.
How long after starting treatment will the patient's condition improve?
As with other antipsychotics, improvement is most often seen within a few days to a few weeks.
Can the drug be used in Parkinson's disease?
Patients with this condition are more sensitive to antipsychotics and the risk of exacerbation of symptoms is increased. Therefore, Latuda is prescribed with caution and provided that the potential benefit to a person outweighs the possible harm.
Is it true that the drug can cause suicidal ideation?
Patients with psychoses are prone to suicidal thoughts and behavior. Cases have been recorded when such reactions occurred at the beginning of therapy and when changing the antipsychotic drug. Therefore, treatment is always carried out under continuous medical supervision.
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Medication | Beacon PCP Toolkit
|Depression||Brand name||Generic||Additional information|
|SSRIs||Z oloft||Sertraline||– https://medlineplus.gov/druginfo/meds/a697048.html|
|Prozac||Fluoxetine||– https://medlineplus. gov/druginfo/meds/a689006.html|
|Paxil, CR||Paroxetine||– https://medlineplus.gov/druginfo/meds/a698032.html|
|IONI||Effexor, XR||Venlafaxine|| – https://medlineplus.gov/druginfo/meds/a694020.html |
|Cymbalta||Duloxetine|| – https://medlineplus.gov/druginfo/meds/a604030.html |
– https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/duloxetine-marketed-cymbalta -information
|Other atypical antidepressants||Wellbutrin, SR, XL||Bupropion||– https://medlineplus. gov/druginfo/meds/a695033.html|
|Alarm||Brand name||Generic||Additional information|
|Other anxiolytics||Buspar||Buspirone||– https://medlineplus.gov/druginfo/meds/a688005.html|
|ADHD||Brand name||Generic||Additional information|
|Methylphenidate||Concert||Methylphenidate||– https://medlineplus. gov/druginfo/meds/a682188.html|
|Focalin, XR D||Methylphenidate|
|Metadata CD, ER||Methylphenidate|
|Ritalin, LA, SR||Methylphenidate|
|Amphetamine||Adderall ; Adderall XR||Mixed amphetamine salts||– https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/adderall-and-adderall-xr-amphetamines-information|
|Other||Catapres||Clonidine||– https://medlineplus. gov/druginfo/meds/a682243.html|
|Intuniv (Tenex)||Guanfacine||– https://medlineplus.gov/druginfo/meds/a601059.html|
|Antipsychotics||Brand name||Generic||Additional information|
|Typical / First generation||Thorazine||Chlorpromazine||– https://medlineplus.gov/druginfo/meds/a682040.html|
|Antipsychotics||Brand name||Generic||Additional information|
|Atypical / Second generation||Abilify, Disc Melt||Aripiprazole||– https://medlineplus. gov/druginfo/meds/a603012.html|
|Abilify Maintena||Aripiprazole IM|
|Risperdal, M||Risperidone||– https://medlineplus.gov/druginfo/meds/a694015.html|
|Seroquel XR||Quetiapine||– https://medlineplus.gov/druginfo/meds/a698019.html|
|Zyprexa, Zidis||Olanzapine||– https://medlineplus.gov/druginfo/meds/a601213.html|
|Mood stabilizers||Brand name||Generic||Additional information|
|Depakote, ER||Valproic acid||– https://medlineplus.|