From the Guidelines
Lurasidone is one of the most weight-neutral antipsychotic options, with a lower risk of weight gain compared to other antipsychotics, making it a preferable choice for patients with weight concerns. According to the study published in 2017 1, lurasidone and ziprasidone appear to be the most weight-neutral in the class, with aripiprazole generally demonstrating a lower risk for weight gain as well. This is in contrast to other antipsychotics such as olanzapine, clozapine, quetiapine, and risperidone, which are consistently associated with weight gain.
Some common side effects of lurasidone include:
- Drowsiness
- Akathisia (restlessness or inability to sit still)
- Nausea
- Insomnia
- Extrapyramidal symptoms (muscle stiffness, tremors, and abnormal movements)
- Metabolic changes (weight gain, though less than other antipsychotics)
- Increases in blood glucose and lipid levels
It is essential to note that lurasidone should be taken with at least 350 calories of food to ensure proper absorption, and patients may experience dizziness when standing up quickly due to orthostatic hypotension. Rarely, serious side effects can occur, including neuroleptic malignant syndrome, tardive dyskinesia, and increased risk of death in elderly patients with dementia-related psychosis. Patients should report any concerning side effects to their healthcare provider immediately, especially suicidal thoughts, severe muscle stiffness, high fever, confusion, or irregular heartbeat.
The weight-neutral profile of lurasidone makes it a valuable option for patients with psychiatric diagnoses who are at risk of weight gain, as weight gain can be a significant concern in this population, often leading to metabolic syndrome and type 2 diabetes 1. Therefore, lurasidone is a preferable choice for patients who require antipsychotic treatment and are at risk of weight gain, due to its weight-neutral profile and lower risk of metabolic side effects compared to other antipsychotics.
From the FDA Drug Label
Lurasidone hydrochloride tablets may cause movements that you cannot control in your face, tongue, or other body parts. Tardive dyskinesia may not go away, even if you stop taking lurasidone hydrochloride tablets. Problems with your metabolism such as: high blood sugar (hyperglycemia) and diabetes. Increases in blood sugar can happen in some people who take lurasidone hydrochloride tablets. Increased fat levels (cholesterol and triglycerides) in your blood. weight gain. Increased prolactin levels in your blood (hyperprolactinemia). Low white blood cell count. Decreased blood pressure (orthostatic hypotension). Falls. Lurasidone hydrochloride tablets may make you sleepy or dizzy, may cause a decrease in your blood pressure when changing position (orthostatic hypotension), and can slow your thinking and motor skills which may lead to falls that can cause fractures or other injuries. Seizures (convulsions) Problems controlling your body temperature so that you feel too warm. Mania or hypomania(manic episodes) in people with a history of bipolar disorder Difficulty swallowing The most common side effects of lurasidone hydrochloride tablets include: Adults with bipolar depression: o restlessness and feeling like you need to move around (akathisia) o difficulty moving, slow movements, muscle stiffness, or tremor o sleepiness or drowsiness Children 10 to 17 years of age with bipolar depression: 1. nausea 2. weight gain 3. problems sleeping (insomnia)
The side effects of Lurasidone include:
- Movement disorders: tardive dyskinesia, akathisia, extrapyramidal symptoms
- Metabolic changes: high blood sugar, diabetes, increased fat levels, weight gain
- Hormonal changes: increased prolactin levels
- Cardiovascular effects: decreased blood pressure, orthostatic hypotension
- Neurological effects: seizures, difficulty swallowing, mania or hypomania
- Common side effects: sleepiness, drowsiness, nausea, problems sleeping 2 The most common adverse reactions in patients treated with lurasidone hydrochloride tablets were:
- Akathisia
- Extrapyramidal symptoms
- Somnolence
- Nausea
- Vomiting
- Diarrhea
- Anxiety 2
From the Research
Lurasidone Side Effects
- The tolerability profile of lurasidone is noteworthy in terms of a good weight and metabolic profile and no cardiovascular adverse effects such as orthostatic hypotension or prolongation of the QTc interval 3.
- Lurasidone is associated with some somnolence, akathisia, nausea, and parkinsonism, especially early in treatment 3.
- Higher rates of akathisia, parkinsonism, and hyperprolactinemia were observed in individuals receiving lurasidone compared to patients treated with other atypical antipsychotics 4.
- Treatment with lurasidone yields a relatively lower risk for developing sedation or overweight/obesity 4.
- Lurasidone may cause irreversible disabling tardive syndrome (TS) as well as parkinsonism, although movement disorders are reported as a rare side effect of lurasidone 5.
- Cases of tardive dystonia, tardive akathisia, and drug-induced parkinsonism have been reported with the use of lurasidone 5.