In June 2013, the FDA expanded its indication for the antipsychotic lurasidone, marketed as Latuda, for use in bipolar disorder, either as a monotherapy or in combination with lithium or valproate. (It was first approved for schizophrenia.)1
Henry Chung, MD, and Joseph Calabrese, MD, director of the Mood Disorders Program at University Hospitals Case Medical Center, Case Western Reserve School of Medicine, presented data on lurasidone, September 22, 2014, during the US Psychiatric and Mental Health Congress in Orlando, Florida. Their presentation was sponsored by Sunovion Pharmaceuticals.1
Lurasidone has been praised in some circles for its relative safety and especially for its lack of adverse cardiometabolic effects, although the FDA does not permit Sunovion to specifically market this aspect. However, in April 2014, writer David Allen, MD, noted that while the drug was superior to other antipsychotics in terms of cardiometabolic effects, the fact that Sunovion had sought FDA approval to prove its effects on bipolar depression did not mean that makers of other, less expensive drugs in the same class would not do the same thing.2
In his portion of the presentation, Chung outlined the toll that bipolar depression takes on patients in terms of lost productivity and costs to the healthcare system. He presented data showing that direct and indirect costs of the disease were $151 billion in 2009. Reducing episodes of depression in these patients, he said, has the potential to trim their overnight hospital stays, visits to the emergency department, and other costs to the system.
The comorbidities associated with severe mental illness are gaining more attention, Chung said. As community health clinics have begun to integrate primary medical care into their services under healthcare reform, there has been an increase in the awareness of the overlay between mental illness and cardiovascular conditions, including the number of mental health patients who have heart attacks, he said.
A patient’s overall cardiometabolic profile would be a consideration for how long a patient might remain on lurasidone, in addition to how well the drug is helping with symptoms of depression. “At no time have we had more incentive to look at both things together,” he said. References
1. Sunovion Pharmaceuticals Inc. announces FDA approval of Latuda (lurasidone HCl) as monotherapy and adjunctive therapy in adult patients with bipolar depression [press release]. Marlborough, MA: Sunovion Pharmaceuticals; June 28, 2013. http://www.sunovion.com/news/latuda-press-room.html.
2. Allen D. Latuda and bipolar depression. Family and Dysfunction and Mental Health blog. http://davidmallenmd.blogspot.com/2014/04/latuda-and-bipolar-depression.html. Published April 8, 2014. Accessed September 23, 2014.