The depressive episodes that accompany bipolar disorder have often perplexed both people who have bipolar disorder and the professionals who want to help treat them. People with ordinary clinical depression — at one time called unipolar depression — often have a few treatment options to choose from, usually starting with psychotherapy or antidepressants.
But using antidepressants in the treatment of depression of someone who has bipolar disorder can have unexpected — and unwanted — effects. Studies of antidepressant use in bipolar disorder have been decidedly mixed.
So it’s always welcome news when a new medication — or a new use for an existing medication — has been approved. Such is the case with Latuda (lurasidone).
Bipolar depression is a frustrating component of bipolar disorder to treat. The most recent meta-analytic study on the use of antidepressants to treat bipolar depression found little support for their use. Two previous meta-analyses came to contradictory conclusions.
The usefulness of antidepressants in bipolar depression therefore remains controversial. Current guidelines generally recommend the cautious antidepressant use in combination with mood stabilizers to reduce the risk of mood elevation or cycle acceleration.
With the arrival of atypical antipsychotic medications, people with bipolar disorder now have an additional treatment choice to help with the alleviation of depression symptoms. Newer doesn’t always mean better, however, especially when it comes to medications. Some new medications’ marketing materials will suggest they have fewer side effects. More often than not, newer medications have a similar number of side effects as older medications — they’re just different ones. Don’t be taken in by pharmaceutical marketing materials.
Latuda (lurasidone) is one such atypical antipsychotic. It was first approved for the treatment of schizophrenia in late 2010; in the summer of 2013, its approved use was extended to help in the treatment of bipolar depression by the U.S. Food and Drug Administration. In schizophrenia, dosing usually starts at 40 mg/daily, but for bipolar depression treatment, 20 mg/daily is recommended. The dose can be increased if needed, but shouldn’t exceed 120 mg/day (160 mg/day in schizophrenia).
Like other atypical antipsychotics, it should be taken with food and it shouldn’t be used in people with liver disease, heart disease, heart problems or a history of heart attacks, or people with high cholesterol.
Latuda is well-tolerated by most people who take it. The most common side effects reported while taking Latuda are somnolence — a strong desire to sleep — (22%) and akathisia — a feeling of inner restlessness that makes it difficult for a person to be able to sit or stay still for long periods of time — (15%). Both of these are dose-related, and can often be controlled by changing the dosing.
Fasting glucose increased — higher blood sugar — (10-14%) and nausea (12%) have also been reported as common side effects. Some people complained of muscle stiffness, or muscle twitching, uncontrollable movements of your eyes, lips, tongue, face, arms, or legs, but these were less common.
Most people who take Latuda are going to start seeing improvement of their symptoms in 3 to 4 weeks. Like all psychiatric medications, Latuda may or may not work for your bipolar depression symptoms. A doctor can’t tell you if it’s going to work for you ahead of time; the only way to know is to try it.
While you are taking Latuda, you may be more sensitive to temperature extremes — so you should avoid getting too cold, or becoming overheated or dehydrated. Drink plenty of fluids, especially in hot weather and during exercise.
The biggest downside to Latuda? Well, because it’s new and still patented, it’s expensive. However, I noticed they do have a savings program that can significantly reduce your co-pay if you qualify.
It’s good to have treatment options, so in that respect, I’m glad to see Latuda is available as one more option to help in the treatment of bipolar depression.
113 comments
Hi to worried mom&all.i grew up within a bipolar family.my great grdma,my grndpaw,my mama,me,my son,now I’m raising my granddaughter with bipolar.i remember(and I’m 48)when I was a tot having to go another state over at least once a year to stay with my grandparents so my dad could work while my mom could go in the hospital.i didn’t have to go to nursing school to get the knowledge of a PhD.that most drs have.I lived it!but to the worried mom&anyone out ther that they try to put ther kids on this or any psychotic Med.(everyones not the same now,but be very cautious)when my granddaughter was put on these new meds(shes 10&only one time did it!)it changed her into somebody we didn’t know or wanta know.last yr in school she was very aggressive,pushed her pregnant teacher several times,smart talking,thought the world hated her so she hated&tLked down to herself all the time.stayed in ISS all the time,her grades were F&Ds,oh&weight gain,sge gained 13pds in 1½ months.And yep lik others it was me that said enuff is enuff!! Take her off put her on Zoloft and see what that does… (an antidepressant,these meds build up kinda like leveling out the “chemical imbalance”that is outa balance in our brains,they build up the serotonin and dopemine on our brain cells causing us to most importantly “FEEL GUD ABOUT OURSELVES”And when you feel gud&have confidence in yourself, WHO CAN TELL YOU ANY DIFFERENT”.So now my gurl is an A/B student,has come out of spec. Ed.and has been referred to the QUEST program which bfore this year she hated reading.now get me wrong she has a few side effects but they do not come close to what we were fighting in school last yr.Those of you that have dealt with this disease for half yr life or the last 10/15 yrs,it doss get easy bc of knowledge,knowing the weapons to fight thes demons with.knowing the warning signs,knowing when enuff is enuff.And to those that believe in the higher power(God)remember he is in control of everything&everybodyhe created our bodies so you can trust he’l help you find your way.To the ones that don’t believe,well I cnt wish you gud luck bc thers no such thing as luck.So to those,I will just pray that God will open your eyes to his truth,why?bc even tho iv seen ones my family go from heaven to the pits of black hell,we are living in a fallen world(thanks to Adam)so we are going to have troubles,problems,sicknessnsss that befall us,but of course God gave us freewill,so that’s why alot of pple are the way they are…. God Bless the ones that believe,recieve&trust in God&his word.To all,please do not give up,tie a knot at the end of that rope and hold on…thers hope.
i am taking this medication 2 years. It’s helps for my schizophrenic symptoms,but totally destroyed my brain.
i lost all my memory, my brain doesn’t work , my brain 0, no cognitive capability, gain weight, i live without brain since i take this medication. Only one problem , i can not live without medication, because the symptoms are terrible.
Taking Latuda lucky my RX plan thru Medicare agreed to pay so it’s around 10 bucks. I hv been on every med on every dose you can imagine. Today psychiatrist do nothing but push meds. The outpatient facility I go to in Va. Just got a psychiatrist I was being treated by a nurse practitioner There are no therapist that accept my insurance so they give me a piece of paper with a list of support groups. I know im going off topic but health care today especially in the area of mental health is a shame
PEOPLE this is nothing more than Pseudoscience there is no scientific evidence this junk works! This junk is nothing but a chemical lobotomy FACT! Think of it this way, folks. Brain cells are like little incandescent light bulbs: they’re electrical, and they burn out. What happens to light bulb filaments after they’ve burned a few hundred hours? psfzzf! Or, you can kill a light bulb in an hour or two, by flicking it ON OFF ON OFF ON. The more you stress the light bulb, the sooner it will expire. This is not an ideal analogy, but it will serve for those who get cross-eyed looking at technical language. Antidepressants and antipsy drugs basically overdrive the little light bulbs in your brain until they fry!!!And then guess what? The same happens to their replacements, until there are NONE LEFT!! You have been lobotomized. That means that your soul has been more or less erased AND NOW YOUR A ZOMBIE. Not only that, but the drug companies know it, because they designed THESE DRUGS for that express purpose. Try to get off these drugs before the damage is done, and you may well be in for symptoms that make heroin withdrawal look like a spa vacation.
Population control! If your big toe hurts they want to put you on meds etc…. They put out children on these meds just for being children… STOP the madness.
My mental illness began in my late teens and early twenties. First treated with trycyclic antidepressants and benzodiazapines . In my late 30s Depakote was added with little improvement. It became obvious to myself and doctor that I was bipolar type II about this time. Finally in my 50s I was treated with quetiapine 500mg and clonazepam 1mg qid. This worked quite well but in about 4 years quit working . Could not increase quetiapine due to its affect on my heart rhythm so 3 months ago my doctor prescribed Latuda 20 mg then increased it to 40 mg. This medicine has been quite effective and my hope is that it will continue to do be so. I had to begin taking armodafinil as Latuda causes me to be drowsy. Both together along with clonazepam has been the best treatment so far to date. He may or may no increase my dosage since I am early in my treatment with this newer medication. Bipolar depression has had an enormous negative effect on my life and has to a lesser extent been bad for my family. I am married with two sons and a wonderful supportive wife. Here’s hoping!!
Wow, that’s the truth!!!
Hello, I have the symptoms of BP2 and not been able to tolerate any medications (CYP450 liver enzyme derangement) except 1 – 2mg Valium if very agitated or speeding up. Now trialling Latuda, in hospital for monitoring. 4 days of 10mg (and in Australia only available in 40mg and 80mg tabs so that is 1/4 of a 40mg tab!!) with no problems then one night (last night) of 20mg when the anxiety started and some mild restless legs. Am still monitoring and assessing whether the anxiety is med caused or worry about side-effects – I think the former as the restless legs also occurred. So back on 10mg tonight and try again with 20mg tomorrow. It is hard to know if it has helped my mood as I am very rapid cycling – yesterday in the pits (and desperate for relief) and today feeling much better. Close monitoring and differential diagnosis of symptoms/side-effects is fortunately not so hard for me as I was an Assessmwnt Nurse!
Since you know CYP450 is affected, have you been evaluated for Acute Intermittent Porphyria?? It causes transient mental disturbances, often accompanied by abdominal pain. I remember a patient describing leg restlessness. There is a treatment that makes the acute episodes subside– iv hematin. Worth ruling out!!! Many drugs affecting CYP450 trigger episodes and must be avoided. I could totally see someone describing AIP as rapid-cycling BP. Esp. if you’re unknowingly being exposed to one of the triggers. There’s an excellent porphyria center in cardiff, UK. Not sure about Oz. 🙂 Best of luck to you!
Rave reviews for myself on 20 mg Latuda, AM and PM. My friends at Peer Support group for Bipolar would go around and rate their mood 1-10, and when it came to me I could give no answer and could only say I seem to have a healthy/normal mood other than I remember having before in my life. Cognitive abilities greatly improved. See evidences of my work on google for Zim Mathematics. I exhibit my work regionally and Nationally annually….. Any one know of Latuda improvements with new medications that maintains the same clinical efficacy, but with less sedation and side effects as with Ability?
Was introduced to Latuda about 2 years ago to help with moodiness and depression associated with Bipolar. The idea was to support me to work a few more years in Real estate sales. Some benefit with the depression, however it snuck up on me that my cognition was declining and I got to the point where I was in panic when I was doing business. Ended up in the hospital with major anxieties and dread. They increased my dosage. Finally I retired, cut back to 30 mg but still suffered. Last week I saw my Psychiatrist. He recommend I start taking Abilify as well in spite of me indicating I was of the belief Latuda was having a negative affect on my cognition and other things. Just what I needed, another antiphyscotic med. To make a long story short he discharged me. I took a couple days to reflect on this path and the reasons I had gone down it and decided to reduce Latuda to 20 mg. After a couple days I am feeling like this was the right move. I may taper down some more as I use up my supply.
By the way I live in Canada and pay less than $150 CD for a months supply. Hold on it gets better, amonths supply is the same no matter what the dosage. Split 120 mg into four you get 4 months, 80 mg into 4. I’m sure you get the picture.
What I have learned from reading what others have experienced is this drug can be a wonder or a horror. The person taking has to determine that and decide what is best for them. The Doctors cannot make the right decisions every time. They aren’t in our heads, they have their own issues confusing the situation and so on and so forth.
I am taking Latuda for the second time in a number of years.
With insurance, I would be paying $1100 or $1200 a month in the U.S., for thirty 20 mg pills. The link takes you to a Canadian drug store in Tarpon Springs, Florida (near Tampa). To them, I pay $200 a month for thirty 20mg pills. Yes, $200 instead of $1200. Brand name. Canada. Take advantage.
I am up to 40mg of Latuda after several weeks. I’m having some trouble with nausea and dizziness this time. Don’t remember experiencing that several years ago when I first took it. I am wondering if those effects will go away soon. My doctor kind of blames Tegretol, which I also take, for the nausea. We’ve gone from 1,000mg of Tegretol to 400. Reducing it has helped. Maybe I’ll just have to go off that, in the end.
I went off Latuda at the beginning of 2018 because it had caused some tardive dyskinesia. I’d been taking 120mg for a while—two and a half years, perhaps? It worked wonderfully for me.
Neither my doctor nor I wanted the T.D., so we took me off the Latuda. We tried for the following 18 months to find a satisfactory substitute. It was 18 months of hell. Nothing worked. My doctor even had me go for a second opinion. (That helped, but not in the way we thought.)
Finally, we tried some Synthroid and then some Effexor. Those helped. But a few months ago, I insisted on going back to Latuda. THANK GOD I did. I feel so much better, finally. Except I have the nausea and dizziness quite badly some days.
Does anyone know whether that will clear up?
I am fortunate and privileged enough to have excellent medication monitoring—right now, I see my psychiatrist every two weeks. Sometimes, during the months from hell, it was more frequent than that. I also see a therapist every week, who is very knowledgeable about medications. I’m unbelievably grateful for both of them, and for getting to work with them so closely.
Call the Canadian pharmacy, if you can afford $200 a month. They’ll need you to fax a three-month prescription to them—you do have to pay for three months at a time. Please don’t let that stop you.
Thank you for this information. I am starting Latuda along with the Zoloft for which I take 150 mg daily, along with 10 mg of buspar. I am extremely depressed with definite bouts of mania. I go in cycles. I am fine a couple weeks then I go into deep depression and stay in bed for days. I rarely leave my house anyway. But I do hope this Latuda helps. Kathy
My doctor and I have discussed how well Latuda could work for me but it is so expensive. I do not have insurance. Are there any programs at all that can help me pay for this medication??!