Lurasidone

SGA / Benzisothiazol·Psychiatry - Oral Antipsychotics

Schizophrenia, Bipolar I Depression

Authority requiredPBSSGALatuda120 mg tablet+2

Max Dose

160 mg/day

Half-life

18 h

Food

350 KCAL REQ.

Bipolar Depress.

INDICATED

Rapid Summary

Overview

Second-Generation Antipsychotic with potent 5-HT7 antagonism. Exceptional efficacy for Bipolar Depression. Extremely safe metabolic profile, but requires a strict caloric intake for absorption.

Maximum Dose

Max 160 mg/day (Schizophrenia) or 120 mg/day (Bipolar Depression).

Clinical Focus

Must be taken with a meal of at least 350 calories. If taken on an empty stomach, blood levels drop by 50% and the drug fails.

Bottom Line

Lurasidone is an atypical antipsychotic effective for bipolar depression with low metabolic risk, but must be taken with food (350 kcal minimum) and causes akathisia.

Formulation & Access

Brand Names

Latuda

Oral Routes

Tablets (20, 40, 80, 120 mg).

Prescribing & PBS

Authority Required (PBS) for Schizophrenia. (Often private script for Bipolar Depression in Aus).

Indications & Use

Primary

PBSTGA

Schizophrenia, Bipolar I Depression.

Clinical Place

The premier antipsychotic for pulling a patient out of a severe bipolar depressive crash without causing the massive weight gain seen with Quetiapine or Olanzapine.

Quick reference

Class & Role

SGA / Benzisothiazol — Second-Generation Antipsychotic with potent 5-HT7 antagonism.

Route / Formulation

Tablets (20, 40, 80, 120 mg). (Latuda)

Usual Dose & Max

PO 20-60 mg OD (evening meal). Max 120 mg/day.

Key Indication Doses

Bipolar Depression: PO 20-60 mg OD (evening meal). Max 120 mg/day. Schizophrenia: PO 40-80 mg OD (evening meal). Max 160 mg/day. Renal / Hepatic Impairment: Max 80 mg/day if eGFR < 50 or moderate hepatic impairment.

Best Uses

Lurasidone is an atypical antipsychotic effective for bipolar depression with low metabolic risk, but must be taken with food (350 kcal minimum) and causes akathisia.

Avoid / Cautions

Concurrent use of strong CYP3A4 inhibitors (Ketoconazole) or inducers (Rifampicin). Pregnancy Category B1. One of the safest antipsychotics to use in pregnant women.

Key Risks

Neurological: Akathisia, EPS (Parkinsonism), somnolence, nausea. Metabolic: Weight neutral, lipid neutral, glucose neutral. (Often used to reverse weight gain from other SGAs). Cardiovascular: Minimal QTc or BP effects.

Key Interactions

CYP3A4 inhibitors (Diltiazem, Clarithromycin) massively spike lurasidone levels. Maximum lurasidone dose is 40 mg/day if on a moderate inhibitor. Avoid strong inhibitors.

Monitoring

Ensure the evening meal contains at least 350 calories. A small salad or an apple is not enough to trigger absorption. It must be a substantial meal. Baseline eGFR to ensure max dose limits.

Clinical Pearl

If a young female with bipolar disorder wishes to become pregnant, switching her from Valproate/Quetiapine to Lurasidone provides exceptional mood stability with Category B1 fetal safety and zero weight gain.

Access

Authority requiredLatuda120 mg tablet

Brand: Latuda
PBS status: Authority required
Formulation: Tablets (20, 40, 80, 120 mg)

Lurasidone

SGA / Benzisothiazol·Psychiatry - Oral Antipsychotics

Schizophrenia, Bipolar I Depression

Authority requiredPBSSGALatuda120 mg tablet+2

Max Dose

160 mg/day

Half-life

18 h

Food

350 KCAL REQ.

Bipolar Depress.

INDICATED

Rapid Summary

Overview

Second-Generation Antipsychotic with potent 5-HT7 antagonism. Exceptional efficacy for Bipolar Depression. Extremely safe metabolic profile, but requires a strict caloric intake for absorption.

Maximum Dose

Max 160 mg/day (Schizophrenia) or 120 mg/day (Bipolar Depression).

Clinical Focus

Must be taken with a meal of at least 350 calories. If taken on an empty stomach, blood levels drop by 50% and the drug fails.

Bottom Line

Lurasidone is an atypical antipsychotic effective for bipolar depression with low metabolic risk, but must be taken with food (350 kcal minimum) and causes akathisia.

Formulation & Access

Brand Names

Latuda

Oral Routes

Tablets (20, 40, 80, 120 mg).

Prescribing & PBS

Authority Required (PBS) for Schizophrenia. (Often private script for Bipolar Depression in Aus).

Indications & Use

Primary

PBSTGA

Schizophrenia, Bipolar I Depression.

Clinical Place

The premier antipsychotic for pulling a patient out of a severe bipolar depressive crash without causing the massive weight gain seen with Quetiapine or Olanzapine.

Quick reference

Class & Role

SGA / Benzisothiazol — Second-Generation Antipsychotic with potent 5-HT7 antagonism.

Route / Formulation

Tablets (20, 40, 80, 120 mg). (Latuda)

Usual Dose & Max

PO 20-60 mg OD (evening meal). Max 120 mg/day.

Key Indication Doses

Best Uses

Lurasidone is an atypical antipsychotic effective for bipolar depression with low metabolic risk, but must be taken with food (350 kcal minimum) and causes akathisia.

Avoid / Cautions

Concurrent use of strong CYP3A4 inhibitors (Ketoconazole) or inducers (Rifampicin). Pregnancy Category B1. One of the safest antipsychotics to use in pregnant women.

Key Risks

Key Interactions

CYP3A4 inhibitors (Diltiazem, Clarithromycin) massively spike lurasidone levels. Maximum lurasidone dose is 40 mg/day if on a moderate inhibitor. Avoid strong inhibitors.

Monitoring

Ensure the evening meal contains at least 350 calories. A small salad or an apple is not enough to trigger absorption. It must be a substantial meal. Baseline eGFR to ensure max dose limits.

Clinical Pearl

Access

Authority requiredLatuda120 mg tablet

Brand: Latuda
PBS status: Authority required
Formulation: Tablets (20, 40, 80, 120 mg)