Mastering Latuda: A Psychiatrist’s Guide
So, I’m a boardcertified child, adolescent, and adult psychiatrist. And it’s my mission to help PMHNPs gain clinical confidence in their diagnosis, treatment, and patient care skills. And I’ve helped over 160 PMH&Ps so far in our coaching program. So, today we’re going to be talking about Laorazzone, Latuda. And so with Latuda, you’re going to learn exactly how to use it with patients, the mechanism of action, the dosing, the unique things about it, the things that you need to watch out for when you’re treating patients, and how to get the most out of this medication so your patients can get benefit. So its mechanism of action, so it does the D2 blockade, dopamine blockade, which is similar to the other antiscychotics, but it also has a lot of mood activity too. And that is from the serotonin antagonism, the 5HT antagonism. And this one, it hits a couple different receptors. So, it’s the 2A, 1A, and the seven. And all of these basically give mood and cognitive benefits. It helps increase the level of and regulate the level of serotonin that the patient has. And so, that’s a big benefit that you get from using Latuda as well. Another thing about it is that the blood pressure has got some alpha 1 antagonism, but it’s weak. So, it doesn’t tend to be as sedating or as orthostatically as some of the other ones as they can do. And then the sedation is minimal as well because this is also decreased. So, just like that is, the H1 is also not that much. And so because the histamine receptor blockade is not that much, the patient’s not going to really get sedated uh from this medication. And then the muscerinic the anticolinergic is also less. So the patient’s not going to really have that many anticolinergic side effects from this. That’s what makes latuda a really good choice for specific reasons. And what it’s used for schizophrenia is a big one. It’s got a lot of efficacy in schizophrenia, especially for the D2 blockade. But a unique use that it has is for bipolar depression, not for bipolar mania. Like you can use it in bipolar mania, especially as you go to higher doses, but the evidence and the FDA approval is not for that. It’s actually for bipolar depression. And so it’s because of all this mood activity. So this is a common choice for clinicians to use if they want a bipolar depression agent that doesn’t have a lot of weight gain associated with it. So that’s a benefit of that for depression. It’s also used for treatment resistant depression TRD and as augmentation. You can give it with an SSRI as augmentation and that can be really helpful. So those are the main things that it is used for. And so for the dosing, typically the dosing, the doses start at 20 mg. So they’ll start at 20 millig and then go to 160. So you start at 20, go to 160. And so typically schizophrenia tends to be around the higher end and then like depression will be here and then bipolar depression will be here. I mean, this is all a gradient, so it’s not like you need to go to the max for schizophrenia and someone with depression may need a higher dose. For example, I have this patient who has treatment and resistant depression. He’s on 80 milligrams of Latuda, but that’s kind of the gradient that you can go with when you’re treating. And the nice thing about Latuda now, Laorazzone, is that it’s cheap. It comes in a 20, 40, comes in a 60, comes in an 80, and a 120. So, it comes in all those different dosage forms. So, it’s pretty easy to dose and yeah, as I mentioned, it’s generic. But the one thing that you got to know about this medication is that it must be dosed with food. So, 350 calories. So, it has to be taken with 350 like, you know, a big meal. So, typically I’ll have patients take it with dinner. That’s the most common time I’ll have them take it because that tends to be most people’s biggest meal of the day. And so I’ve had clinicians or patients say, “Hey, I’m not getting a benefit from Latuda.” They might be on higher doses than they need to because they’re not taking it with food. It gets absorbed better with food. So always tell the patient, take this med with your biggest meal. And typically, it could even be like lunch or breakfast as long as the patient’s not getting sedated. And sedation is pretty low with this med. So that’s what gives you a lot of flexibility. So if we talk about side effects, the biggest one that Latuda has is athesia or restlessness. Not as much as ailifi, but it’s definitely a common side effect. The EPS is also a big one as well. EPS is another big side effect related to Latuda laurazzone. But other than that, the nice thing about it is that sedation is not much and weight gain is not much either. That is nice because it doesn’t have all the histamine activity. So this is a very metabolically neutral anticycchotic that’s important to the patient. Then this is an option you can lean towards. Of course, you still want to monitor the patient with the A1C regardless. So you still want to do yearly checks. for A1C lipids, but the risk is less, which is nice. Another nice thing is decrease antiolinergic activity and um decrease QTC prolongation. Overall, this is a very clean med to use and a lot of patients will find benefit from it. So, it’s definitely something I would recommend you leaning more into if you haven’t been using this already. The nice thing is that it’s got a long halflife about 18 hours. So you can just give it once a day to the patient and they’re fine because of that. It tends to be absorbed pretty well as long as it’s given with food. Overall with Latuda things you got to know bipolar depression it can be used for augmentation for treatment resistant depression higher doses used for schizophrenia. very metabolically neutral, not sedating, not anticolineric. Just be wary of some EPS risk and acthesia. Other than that, it’s a great choice for people if they can remember to take it
PMHNP Coaching
https://www.skool.com/level-up-psych-academy
Book a Patient Consult:
https://www.agamdhawanmd.com/consult
Join me, a board-certified psychiatrist, as I dive deep into the uses, dosage, mechanisms, and key considerations for prescribing Latuda (lurasidone). This video is specially designed for PMHNPs, covering its application in schizophrenia, bipolar depression, and treatment-resistant depression. Learn about its mechanism of action, potential side effects, and the importance of taking it with food. Ideal for PMHNPs looking to enhance their understanding and clinical confidence in using Latuda effectively.
00:00 Introduction and Mission
00:17 Overview of Lurasidone (Latuda)
00:37 Mechanism of Action
01:55 Clinical Uses and Benefits
02:57 Dosing Guidelines
03:57 Administration Tips
04:50 Side Effects and Monitoring
06:25 Conclusion and Recommendations