Does Latuda Cause Sedation?
Yes, Latuda (lurasidone) causes sedation in a clinically significant proportion of patients, with somnolence occurring in 7–14% of adults and 11% of pediatric patients, compared to 5–7% with placebo. 1
Sedation Incidence by Population and Indication
Bipolar Depression in Adults
- Monotherapy: Somnolence was reported in 7.3% of patients receiving lurasidone 20–60 mg/day and 13.8% receiving 80–120 mg/day, compared to 6.5% with placebo. 1
- Adjunctive therapy with lithium or valproate: Somnolence occurred in 11.4% of patients on lurasidone 20–120 mg/day versus 5.1% on placebo. 1
Pediatric Patients (10–17 Years)
- In the 6-week bipolar depression study, somnolence was reported in 11.4% of patients receiving lurasidone 20–80 mg/day compared to 5.8% with placebo. 1
Schizophrenia
- Somnolence is recognized as one of the common adverse effects in schizophrenia treatment, particularly early in therapy, though it is often transitory and manageable with dose adjustment. 2, 3
Dose-Dependent Sedation Risk
Higher doses of lurasidone are associated with increased sedation. 4
- The recommended starting dose is 40 mg/day with a maximum of 80 mg/day; doses above 80 mg may increase adverse effects including somnolence without additional efficacy benefit. 4
- In one study, doses up to 160 mg/day did not show the expected increase in tolerability issues, but this finding requires replication. 4
Clinical Implications and Management
Lurasidone has the potential to impair judgment, thinking, or motor skills due to its sedative effects. 1
- Patients should be cautioned about operating hazardous machinery, including motor vehicles, until they are reasonably certain that lurasidone does not affect them adversely. 1
- Most sedation-related side effects with lurasidone are transitory, easily managed, and/or ameliorated by dose adjustment. 3
Fall Risk Considerations
Lurasidone may cause somnolence, postural hypotension, and motor/sensory instability, which can lead to falls and consequent fractures or other injuries. 1
- Complete fall risk assessments should be performed when initiating lurasidone and recurrently for patients on long-term therapy, especially in those with diseases, conditions, or medications that could exacerbate these effects. 1
Comparative Context
Unlike some other antipsychotics, lurasidone is associated with minimal weight gain and no clinically meaningful alterations in glucose, lipids, or QT interval, making sedation one of its primary tolerability concerns rather than metabolic effects. 4, 2
- Patients switching to lurasidone from sedating antipsychotics (olanzapine or quetiapine) may experience changes in sedation profile during the transition period. 5
- The treatment failure rate was higher (11.6%) in patients switching from sedating antipsychotics compared to nonsedating agents (5.8%). 5
Important Prescribing Considerations
- Lurasidone should be administered once daily with at least 350 calories of food to ensure proper absorption. 4
- No titration is needed when starting lurasidone, but dose adjustment may be necessary if sedation becomes problematic. 2
- Sedation typically occurs early in treatment and may improve over time with continued therapy. 2, 3