Latuda

[shahseh22]

Has anyone seen this medication actually work as an adjunct to an SSRI? I am getting some patient's who have been discharged from the hospital (discharge summary is still missing unfortunately) with a diagnosis of MDD and they are being started on Zoloft & Latuda for some reason. They do not appear to be manic/hypomanic so I'm only assuming its as an adjunct.

I feel very strongly that we should maximize an SSRI prior to using adjuncts. I also do not like using antipsychotics due to side effect potential, so I am planning on tapering these people off of it gradually.

On a related note, regarding its formulation, since it does require to be taken with a meal, can I simply tell a pt who is taking 40 mg tab, to cut it in half for 1 week (20 mg) to discontinue? Or does it lose efficacy if you do it that way? Silly question, but not sure.

Thanks

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[Attending1985]

Seen one person who claims it works but I’m skeptical he’s a polypharmscy disaster I inherited. Only have seen it cause akathisia otherwise. I don’t like using antipsychotics either I would taper too. If they’ve been on it a short time I would just stop it.

 

[Trismegistus4]

Isn't it FDA-approved only for schizophrenia and bipolar depression, not as an adjunct in MDD? Are these people actually getting insurance to cover it without a bipolar or schizophrenia diagnosis?

 

[clausewitz2]

Isn't it FDA-approved only for schizophrenia and bipolar depression, not as an adjunct in MDD? Are these people actually getting insurance to cover it without a bipolar or schizophrenia diagnosis?

Our captive insurer will usually cover it but they do require prior authorization with documented previous treatment failures.

The manufacturer is pursuing an indication for MDD. Otherwise patent expires this year, so hopefully generics in the near future.

Side effect wise at least it is more or less weight neutral. Sure if no adequate SSRI trial has been done don't adjunct but if they have already tried a couple without much luck don't be one of those people who just picks another one.

 

[shahseh22]

Can the pill be cut in half (40mg-->20 mg)?

 

[shahseh22]

I'm just not sure if the pill can be cut in half or if I have to call in another 20 mg of Latuda and tell the patient to throw away the 40 mg tablet.

 

[Liquid8]

Have had some good results using lurasidone with bipolar depression, but haven't really considered it as one of my go-to anti-depressant augmentation choices.