Lurasidone in the Treatment of Bipolar Depression: Systematic Review of Systematic Reviews

Fornaro, Michele; Berardis, Domenico De; Perna, Giampaolo; Solmi, Marco; Veronese, Nicola; Orsolini, Laura; Buonaguro, Elisabetta Filomena; Iasevoli, Felice; Köhler, Cristiano A.; Carvalho, André F.; Bartolomeis, Andrea de

doi:10.1155/2017/3084859

Cited by 24 publications

(21 citation statements)

References 100 publications

(139 reference statements)

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“…However, long‐term cohort studies in this age group are clearly warranted. All antipsychotics have more adverse events than lithium according to this meta‐review, except for lurasidone, which seems to have a comparably safe profile and could be preferred to lithium for the treatment of bipolar depression 193,194 .…”

Section: Discussionmentioning

confidence: 90%

Safety of 80 antidepressants, antipsychotics, anti‐attention‐deficit/hyperactivity medications and mood stabilizers in children and adolescents with psychiatric disorders: a large scale systematic meta‐review of 78 adverse effects

et al. 2020

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Mental disorders frequently begin in childhood or adolescence. Psychotropic medications have various indications for the treatment of mental disorders in this age group and are used not infrequently off‐label. However, the adverse effects of these medications require special attention during developmentally sensitive periods of life. For this meta‐review, we systematically searched network meta‐analyses and meta‐analyses of randomized controlled trials (RCTs), individual RCTs, and cohort studies reporting on 78 a priori selected adverse events across 19 categories of 80 psychotropic medications – including antidepressants, antipsychotics, anti‐attention‐deficit/hyperactivity disorder (ADHD) medications and mood stabilizers – in children and adolescents with mental disorders. We included data from nine network meta‐analyses, 39 meta‐analyses, 90 individual RCTs, and eight cohort studies, including 337,686 children and adolescents. Data on ≥20% of the 78 adverse events were available for six antidepressants (sertraline, escitalopram, paroxetine, fluoxetine, venlafaxine and vilazodone), eight antipsychotics (risperidone, quetiapine, aripiprazole, lurasidone, paliperidone, ziprasidone, olanzapine and asenapine), three anti‐ADHD medications (methylphenidate, atomoxetine and guanfacine), and two mood stabilizers (valproate and lithium). Among these medications with data on ≥20% of the 78 adverse events, a safer profile emerged for escitalopram and fluoxetine among antidepressants, lurasidone for antipsychotics, methylphenidate among anti‐ADHD medications, and lithium among mood stabilizers. The available literature raised most concerns about the safety of venlafaxine, olanzapine, atomoxetine, guanfacine and valproate. Nausea/vomiting and discontinuation due to adverse event were most frequently associated with antidepressants; sedation, extrapyramidal side effects, and weight gain with antipsychotics; anorexia and insomnia with anti‐ADHD medications; sedation and weight gain with mood stabilizers. The results of this comprehensive and updated quantitative systematic meta‐review of top‐tier evidence regarding the safety of antidepressants, antipsychotics, anti‐ADHD medications and mood stabilizers in children and adolescents can inform clinical practice, research and treatment guidelines.

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Section: Discussionmentioning

confidence: 90%

Safety of 80 antidepressants, antipsychotics, anti‐attention‐deficit/hyperactivity medications and mood stabilizers in children and adolescents with psychiatric disorders: a large scale systematic meta‐review of 78 adverse effects

et al. 2020

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“…All these mechanisms are based on the ability of some atypical antipsychotics to increase serotonin, dopamine, and norepinephrine levels, while reducing those of glutamate [37,38]. Atypical antipsychotics are indicated in schizophrenia, and most of them also in mania, but quetiapine is the only one approved for bipolar conditions, while lurasidone has only been tested [39,40].…”

Section: Atypical Antipsychoticsmentioning

confidence: 99%

Pharmacogenomic Characterization in Bipolar Spectrum Disorders

et al. 2019

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The holistic approach of personalized medicine, merging clinical and molecular characteristics to tailor the diagnostic and therapeutic path to each individual, is steadily spreading in clinical practice. Psychiatric disorders represent one of the most difficult diagnostic challenges, given their frequent mixed nature and intrinsic variability, as in bipolar disorders and depression. Patients misdiagnosed as depressed are often initially prescribed serotonergic antidepressants, a treatment that can exacerbate a previously unrecognized bipolar condition. Thanks to the use of the patient's genomic profile, it is possible to recognize such risk and at the same time characterize specific genetic assets specifically associated with bipolar spectrum disorder, as well as with the individual response to the various therapeutic options. This provides the basis for molecular diagnosis and the definition of pharmacogenomic profiles, thus guiding therapeutic choices and allowing a safer and more effective use of psychotropic drugs. Here, we report the pharmacogenomics state of the art in bipolar disorders and suggest an algorithm for therapeutic regimen choice.

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“…Lurasidone has high antagonist activity at serotonin 5-HT 2A and 5-HT 7 receptors and weaker antagonism at dopamine D 2 receptor [ 99 ]. It has also partial agonist activity at serotonin 5-HT 1A receptor, considerable affinity to adrenergic α 2A and weaker affinity to muscarinic receptors [ 99 ]. Lurasidone is used for treatment of schizophrenia acute bipolar depression.…”

Section: Multi-target Compounds To Treat Schizophreniamentioning

confidence: 99%

“…Lurasidone is used for treatment of schizophrenia acute bipolar depression. It has low probability of side effects typical for second generation antipsychotics, but higher risk of akathisia in comparison to other atypicals [ 99 ].…”

Section: Multi-target Compounds To Treat Schizophreniamentioning

confidence: 99%

Multi-Target Approach for Drug Discovery against Schizophrenia

Kondej

Stępnicki

Kaczor

2018

IJMS

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Polypharmacology is nowadays considered an increasingly crucial aspect in discovering new drugs as a number of original single-target drugs have been performing far behind expectations during the last ten years. In this scenario, multi-target drugs are a promising approach against polygenic diseases with complex pathomechanisms such as schizophrenia. Indeed, second generation or atypical antipsychotics target a number of aminergic G protein-coupled receptors (GPCRs) simultaneously. Novel strategies in drug design and discovery against schizophrenia focus on targets beyond the dopaminergic hypothesis of the disease and even beyond the monoamine GPCRs. In particular these approaches concern proteins involved in glutamatergic and cholinergic neurotransmission, challenging the concept of antipsychotic activity without dopamine D2 receptor involvement. Potentially interesting compounds include ligands interacting with glycine modulatory binding pocket on N-methyl-d-aspartate (NMDA) receptors, positive allosteric modulators of α-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors, positive allosteric modulators of metabotropic glutamatergic receptors, agonists and positive allosteric modulators of α7 nicotinic receptors, as well as muscarinic receptor agonists. In this review we discuss classical and novel drug targets for schizophrenia, cover benefits and limitations of current strategies to design multi-target drugs and show examples of multi-target ligands as antipsychotics, including marketed drugs, substances in clinical trials, and other investigational compounds.

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Lurasidone in the Treatment of Bipolar Depression: Systematic Review of Systematic Reviews

Cited by 24 publications

References 100 publications

Safety of 80 antidepressants, antipsychotics, anti‐attention‐deficit/hyperactivity medications and mood stabilizers in children and adolescents with psychiatric disorders: a large scale systematic meta‐review of 78 adverse effects

Safety of 80 antidepressants, antipsychotics, anti‐attention‐deficit/hyperactivity medications and mood stabilizers in children and adolescents with psychiatric disorders: a large scale systematic meta‐review of 78 adverse effects

Pharmacogenomic Characterization in Bipolar Spectrum Disorders

Multi-Target Approach for Drug Discovery against Schizophrenia

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