药品详情：
【济民医药导读】鲁拉西酮Latuda是一类精神治疗新药，用于青少年精神分裂症，这也是近几年来第一种获批治疗13-17岁年龄段精神分裂症患者的药物。
一组临床试验开展，分别使用鲁拉西酮Latuda 40mg、80mg或安慰剂治疗两个月的时间，结果显示，相比于安慰剂，两种剂量的鲁拉西酮Latuda均可令病情改善，且耐受性总体良好。据以往研究显示，相对于成年期精神分裂症患者，青少年期的精神类症状可能更为严重，更难以治疗，因此本次试验的成果，成为FDA批准鲁拉西酮Latuda上市销售的一大因素。
研究者Robert Findeing博士指出：“考虑到青少年起病对发育的影响，及较难治疗的效果，针对这一患者群体的治疗需要耐受性及疗效兼顾的治疗方案。”鲁拉西酮Latuda无疑为治疗这一类的精神疾病患者提供了另外一种治疗方案。
Latuda(lurasidone)
Lurasidone, sold under the trade name Latuda among others, is an antipsychotic medication used to treat schizophrenia and bipolar disorder.[1] In bipolar it may be used together with a mood stabilizers such as lithium or valproate.[1] It is taken by mouth.[1]
Common side effects include sleepiness, movement disorders, nausea, and diarrhea.[1]Serious side effects may include the potentially permanent movement disorder tardive dyskinesia, as well as neuroleptic malignant syndrome, an increased risk of suicide, angioedema, and high blood sugar levels.[1] In older people with psychosis as a result of dementia, it may increase the risk of dying.[1] Use during pregnancy is of unclear safety.[4]How it works is not clear but is believed to involve effects on dopamine and serotonin in the brain.[1]
Lurasidone was approved for medical use in the United States in 2010.[1] A month supply in the United Kingdom costs the NHS about 90.72 £ as of 2019.[4] In the United States the wholesale cost of this amount is about 190.20 USD.[5] In 2016, it was the 227th most prescribed medication in the United States, with more than 2.2 million prescriptions.[6]
Medical uses
Lurasidone is used for the treatment of schizophrenia and bipolar disorder.[1]
In a 2013 study in a comparison of 15 antipsychotic drugs in effectiveness in treating schizophrenic symptoms, lurasidone demonstrated mild effectiveness. As effective as iloperidone, and 13 to 15% less effective than ziprasidone, chlorpromazine, and asenapine.[7]
In July 2013 lurasidone received approval for bipolar I depression.[8][9] Few available atypical antipsychotics are known to possess antidepressant efficacy in bipolar disorder (with the notable exceptions being quetiapine,[10][11][12][13] olanzapine[14][15][16] and possibly asenapine[17]) as a monotherapy, even though the majority of atypical antipsychotics are known to possess significant antimanic activity,[18] which is yet to be clearly demonstrated for lurasidone.
Lurasidone is not approved by the Food and Drug Administration (FDA) for the treatment of behavior disorders in older adults with dementia.[19]
Contraindications
Lurasidone is contraindicated in individuals who are taking strong inhibitors of the liver enzyme CYP3A4 (ketoconazole, clarithromycin, ritonavir, levodropropizine, etc.) or inducers (carbamazepine, St. John's wort, phenytoin, rifampicin etc.).[20] The use of lurasidone in pregnant women has not been studied and is not recommended; in animal studies, no risks have been found.[21] Excretion in breast milk is also unknown; lurasidone is not recommended for breastfeeding women.[22] In the United States it is not indicated for use in children.[23]
Adverse effects
Side effects are generally similar to other antipsychotics. The drug has a relatively well-tolerated side effect profile, with low propensity for QTc interval changes, weight gain and lipid-related adverse effects.[24] In a 2013 meta-analysis of the efficacy and tolerability of 15 antipsychotic drugs it was found to produce the second least (after haloperidol) weight gain, the least QT interval prolongation, the fourth most extrapyramidal side effects (after haloperidol, zotepine and chlorpromazine) and the sixth least sedation (after paliperidone, sertindole, amisulpride, iloperidone and aripiprazole).[7]
As with other atypical neuroleptics, lurasidone should be used with caution in the elderly because it puts them at an increased risk for a stroke or transient ischemic attack;[25][26]however, these risks are not likely to be greater than those associated with antipsychotics of other classes.[27] Similarly, lurasidone should not be used to treat dementia-related psychosis, as evidence has shown increased mortality with antipsychotic use.
Weight gain is reported in up to 15 and 16 percent of users.
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