Lurasidone Improves Psychopathology and Cognition in Treatment-Resistant Schizophrenia.

Abstract

PURPOSE/BACKGROUND:

In addition to clozapine, other atypical antipsychotic drugs pharmacologically similar to clozapine, for example, olanzapine, risperidone, and melperone, are also effective in a similar proportion of treatment-resistant schizophrenia (TRS) patients, ~40%. The major goal of this study was to compare 2 doses of lurasidone, another atypical antipsychotic drug, and time to improvement in psychopathology and cognition during a 6-month trial in TRS patients.

METHODS/PROCEDURES:

The diagnosis of TRS was based on clinical history and lack of improvement in psychopathology during a 6-week open trial of lurasidone 80 mg/d (phase 1). This was followed by a randomized, double-blind, 24-week trial of lurasidone, comparing 80- and 240-mg/d doses (phase 2).

FINDINGS/RESULTS:

Significant non-dose-related improvement in the Positive and Negative Syndrome Scale-Total and subscales and in 2 of 7 cognitive domains, speed of processing and executive function, were noted. Twenty-eight (41.8%) of 67 patients in the combined sample improved ≥20% in the Positive and Negative Syndrome Scale-Total. Of the 28 responders, 19 (67.9%) first reached ≥20% improvement between weeks 6 and 24 during phase 2, including some who had previously failed to respond to clozapine.

IMPLICATIONS/CONCLUSIONS:

Improvement with lurasidone is comparable with those previously reported for clozapine, melperone, olanzapine, and risperidone in TRS patients. In addition, this study demonstrated that 80 mg/d lurasidone, an effective and tolerable dose for non-TRS patients, was also effective in TRS patients but required longer duration of treatment. Direct comparison of lurasidone with clozapine in TRS patients is indicated.

• Authors: Herbert Y Meltzer, Daniel B Share, Karu Jayathilake, Ronald M Salomon, Myung A Lee
• Journal: Journal of clinical psychopharmacology (J Clin Psychopharmacol) 2020 May-Jun Vol. 40 Issue 3 Pg. 240-249 ISSN: 1533-712X [Electronic] United States
• PMID: 32332459 (Publication Type: Clinical Trial, Phase II, Journal Article, Randomized Controlled Trial)

Chemical References

• Antipsychotic Agents
• Lurasidone Hydrochloride

Topics

• Adult
• Antipsychotic Agents (adverse effects, therapeutic use)
• Double-Blind Method
• Drug Resistance (drug effects)
• Female
• Humans
• Lurasidone Hydrochloride (adverse effects, therapeutic use)
• Male
• Psychiatric Status Rating Scales
• Schizophrenia (drug therapy)
• Schizophrenic Psychology
• Treatment Outcome