Can buspirone paired with Latuda (lurasidone) help decrease sexual side effects like vaginal dryness?

Buspirone with Latuda for Sexual Side Effects Like Vaginal Dryness

Buspirone may be considered as an off-label option for sexual dysfunction including vaginal dryness in patients taking Latuda (lurasidone), though evidence specifically for this combination is limited. 1

Treatment Options for Sexual Dysfunction with Antipsychotics

Primary Approaches for Vaginal Dryness

• Vaginal estrogen is the most effective treatment for vaginal dryness leading to sexual dysfunction and has been shown to effectively treat itching, discomfort, and painful intercourse in postmenopausal individuals 2
• Vaginal moisturizers, gels, and oils can help alleviate symptoms such as vaginal dryness and sexual pain, although data on these over-the-counter products are limited 2
• Vaginal DHEA (prasterone) can be considered for vaginal dryness or pain with sexual activity, with studies showing improvements in sexual desire, arousal, pain, and overall sexual function 2

Medication Options for Sexual Dysfunction

• Buspirone is considered an off-label option for low sexual desire or libido with limited data but is recognized by expert panels as a potential option 2, 1
• In a small study of patients with generalized anxiety disorder, buspirone normalized sexual function in 8 of 10 patients, suggesting it may have advantages over other anxiolytics that typically impair sexual function 3
• Unlike many psychotropic medications, buspirone has not been associated with significant sexual dysfunction and may be considered when sexual side effects are a concern 4

Mechanism and Evidence

• Lurasidone (Latuda) is a second-generation antipsychotic with a lower risk of inducing weight gain and metabolic abnormalities compared to other antipsychotics, but its effects on sexual function require consideration 5
• Buspirone, as a partial 5HT1A receptor agonist, may help counteract some sexual side effects caused by medications that affect serotonergic pathways 4
• In a study of premenstrual dysphoria, sexual dysfunction was not significantly more common in patients given buspirone than in those given placebo, suggesting a favorable sexual side effect profile 4

Treatment Algorithm for Sexual Dysfunction with Latuda

1. First-line approaches for vaginal dryness:

   • Topical vaginal therapies including moisturizers and lubricants 2
   • Consider vaginal dilators for pain with sexual activity 2

2. For persistent symptoms:

   • Consider adding buspirone (typically 15-30 mg/day) as an off-label option for addressing sexual dysfunction 1
   • Bupropion is another off-label medication option that may be considered 2, 1

3. For severe cases or when above options are ineffective:

   • Consider referral to a sexual health specialist for comprehensive evaluation 2
   • Pelvic physical therapy may help improve sexual pain, arousal, lubrication, and satisfaction 2

Important Considerations

• The combination of buspirone with Latuda has not been extensively studied specifically for sexual side effects, so monitoring for effectiveness and side effects is important 1
• Buspirone typically requires several weeks of consistent use before benefits for sexual function may be observed 3
• Sexual dysfunction is often multifactorial, and addressing psychological factors through referrals to specialists (psychotherapy, sexual/couples counseling) may be necessary alongside medication approaches 2
• For premenopausal women with low sexual desire, FDA-approved options like flibanserin or bremelanotide could be considered if buspirone is ineffective 1

Cautions

• Avoid phosphodiesterase type 5 inhibitors for female sexual dysfunction as they have shown contradictory results in clinical trials 2
• Ospemifene should only be considered for dyspareunia in survivors without a history of estrogen-dependent cancers 2
• Monitor for potential drug interactions between buspirone and Latuda, though significant interactions are not commonly reported 5