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Lurasidone for Treating Teen Mental Health (And Side Effects to Look Out For)

Author:
Eilaf Meenai
Eilaf Meenai
MD
Editor:
Emma Loker
Emma Loker
B.S.
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When medication is needed to make teen mental health challenges feel more under control, it can sometimes cause more concerns than it eases – especially when this medication is an antipsychotic. 

Lurasidone (Latuda) is part of a class of drugs known as “atypical” or “second-generation” antipsychotics. It’s FDA-approved to treat schizophrenia in teens aged 13–17 and bipolar I disorder in those aged 10–17.

In real-world use, Latuda is often prescribed to teens dealing with severe mood swings, aggression, irritability, or psychotic symptoms. And like any prescription medication, it’s not without risks.

A mental health professional can discuss whether Latuda could be suitable for your child’s needs. This article can also act as a valuable guide, covering:

  • What Lurasidone is and how it works
  • How long it takes for Latuda to work in teens
  • How Latuda can benefit teen mental health
  • Guidance of Latuda dosage for teenagers
  • The common side effects of lurasidone in teens
  • How lurasidone compares to other antipsychotics
  • Where to find the right support for teen mental health
Lurasidone for Treating Teen Mental Health

What Is Lurasidone (Latuda)?

Lurasidone is an atypical antipsychotic, part of a newer generation of antipsychotics that help with mental health conditions like schizophrenia and bipolar depression. 

Latuda is FDA-approved for the treatment of schizophrenia in both adults and adolescents (13+). It’s also approved for treating bipolar depression in adults and children (10+ years old), either as a solo medication or in combination with a mood stabilizer.1

When it comes to side effects, lurasidone is less likely to cause weight gain or mess with your blood sugar and cholesterol as much as some other antipsychotics do. It also doesn’t tend to cause sedation or cognitive dulling as much as some other drugs. We discuss potential Latuda side effects further later in this article.

How Latuda Works in Treating Mental Health Conditions

Latuda acts on your brain’s dopamine and serotonin systems. By doing so, it helps to regulate the receptors responsible for thought, emotion, sleep, and cognition. 

Dopamine overactivity in the brain is thought to drive psychotic symptoms like hallucinations and delusions. Lurasidone works to improve these symptoms by blocking dopamine receptors in this area of the brain, which helps calm the overdrive.

However, blocking dopamine in the entire brain is not what we want because dopamine activity also controls movement. Therefore, too much dopamine blockage can result in tremors and stiffness. That is where serotonin modulation comes in. 

Lurasidone also blocks serotonin receptors, which indirectly protects dopamine in other brain pathways from being shut down too much. 

The dual activity at dopamine and serotonin receptors allows the drug to treat psychosis without causing heavy motor side effects like rigidity or restlessness. 

What makes lurasidone interesting is its blocking effects at the 5-HT7 receptor. 5-HT7 is involved in cognitive function, mood regulation, and circadian rhythm. Blocking this receptor explains why Latuda seems to offer both cognitive and antidepressant benefits.2

Additionally, lurasidone has minimal or no activity at histamine and muscarinic receptors, which are often associated with:

  • Sedation
  • Weight gain
  • Dry mouth
  • Brain fog

Due to this “cleaner” receptor profile, people on lurasidone report less weight gain and grogginess than with other antipsychotics.

How Long Does It Take for Latuda to Work in Teens?

Latuda reaches the peak blood levels fairly quickly, within one to three hours after taking it. However, clinical effects like mood improvement or reduced psychotic symptoms don’t happen instantly; they typically take at least one to two weeks to show.

Latuda’s half-life is approximately 18 hours, so it remains active in the body long enough to support once-daily dosing. However, it takes the drug roughly one week to build up a consistent blood level.1 This means that people usually start to see an improvement after this time. 

Only 9–19% of the Latuda dose is absorbed by the body, and the rest is excreted. Also, it must be taken with food (at least 350 calories) for proper absorption.

Lurasidone’s Important Uses for Teen Mental Health

The FDA has approved Latuda for schizophrenia and bipolar I disorder only. However, studies have shown that it works to improve the symptoms of several other mental health conditions. Here’s what research has to say about the key uses of Latuda for teen mental health. 

Latuda for Treating Adolescent Schizophrenia

Lurasidone earned FDA approval in January 2017 for treating adolescent schizophrenia in teens aged 13 to 17 years. The foundation for this approval was an experiment on adolescents diagnosed with schizophrenia, in which teens receiving Latuda showed a significant reduction in psychotic symptoms.3

What’s more, Latuda also scored well on tolerability. This means that the rates of side effects, such as weight gain and sedation, were lower than with other atypical antipsychotics. For these reasons, Latuda remains a valuable treatment option for teens with schizophrenia.

Lurasidone for Teen Bipolar Disorder

Bipolar depression is the low-energy, withdrawn, irritable aspect of bipolar disorder, which tends to be harder to treat than mania and is a major cause of functional impairment in teens.

Just over a year after Latuda was approved for treating schizophrenia, in March 2018, the FDA expanded Latuda’s uses to include bipolar depression in patients aged between 10–17 years. Evidence suggests that Latuda helps to make life more manageable for teens with bipolar depression as it boosts mood, energy, sleep, and cognitive function more than a placebo (sugar pill).4

Off-Label Uses of Latuda

While Latuda is only FDA-approved for schizophrenia and bipolar depression in youth, it’s also being cautiously explored for off-label use in tough-to-treat adolescent cases. Off-label prescribing simply means that a medication can be used for a condition it’s not yet officially approved for. 

For instance, in a study, doctors reviewed six adolescents who were prescribed Latuda for complex, hard-to-manage conditions. Severe depression, psychosis with eating disorders, or treatment-resistant mood instability were among the diagnoses that were looked at.5

In three of these cases, Latuda showed major symptom improvements. Yet two of these cases showed mixed results, and one didn’t show any benefit. 

However, the effects of Latuda also showed improvements for a teen with a history of psychosis and a comorbid eating disorder. This teen had previously not responded well to other medications, and Latuda didn’t worsen the symptoms of their eating disorder – demonstrating how tolerable the medication can be.6

Finally, another experiment suggested that Latuda may offer benefits in reducing irritability, aggression, and emotional dysregulation in some children and adolescents with autism spectrum disorder (ASD).7

Latuda Dosage for Teenagers

Latuda comes in 20 mg, 40 mg, 80 mg, and 120 mg tablets. The dosage can depend on what’s being treated, the person’s age, and how well they tolerate the medication. 

For schizophrenia, the starting dose is 40 mg once daily, taken with food. From there, the dosage can be increased up to 160 mg per day depending on the severity of symptoms and the side effects experienced.

Latuda for bipolar depression in adolescents is started at a lower dose. The initial dose is 20 mg once daily, again with food, and the recommended range is 20 to 120 mg per day. Many adolescents do well on mid-range doses like 40 or 60 mg, and not everyone needs to hit the top end of the dosing spectrum.1 The aim is to provide the lowest possible dose while achieving positive results.

Special attention to dosing is needed for people with kidney or liver disease. If a teen has moderate to severe kidney or liver problems, Latuda is scaled down to avoid excessive drug levels in the body. In these cases, doctors typically start at 20 mg per day, with a maximum dose of 80 mg per day for moderate kidney or liver issues. The dose is capped at 40 mg per day if liver disease is severe.1

Latuda is metabolized by the CYP3A4 enzyme, which means other medications that affect this enzyme can significantly change how Latuda behaves in the body. For instance, it shouldn’t be taken with strong CYP3A4 inhibitors (like ketoconazole) and strong CYP3A4 inducers (like rifampin). 

You should also take Latuda once a day, ideally at the same time each day. It doesn’t matter what time of day you choose as long as it works for your routine. Just make sure to take it with a meal that has at least 350 calories. 

How Long Should Teens Take Latuda For?

Once a teen has been diagnosed with schizophrenia and responds well to Latuda, the general clinical recommendation is to continue treatment. Since schizophrenia is a long-term condition, stopping medication too soon raises the risk of relapse.

In the case of bipolar disorder, lurasidone is used during depressive episodes. Once the episode has stabilized, the decision to continue lurasidone as a maintenance medication depends on the teen’s history of mood episodes. 

If a teen has had multiple episodes, doctors often keep them on a mood stabilizer or antipsychotic (like lurasidone) indefinitely, or for at least 6–12 months after symptoms are gone. However, if it’s a first episode and the teen remains stable, the care team will reassess at six months to consider stopping the drug. 

Common Side Effects of Lurasidone in Teenagers

Lurasidone is generally well-tolerated in teens and children, but it’s not without side effects. These effects often ease after a period of adjustment, but may also persist. The most common side effects of the drug in children and teens include:3

  • Excessive drowsiness or sleepiness
  • Sedation
  • Stomach discomfort
  • Vomiting

Less common but clinically important side effects that showed up in clinical studies include:

  • Akathisia, which is an intense sense of inner restlessness
  • Parkinsonism, a movement disorder that causes stiffness, slowed movement, and tremor
  • Sudden, painful muscle contractions
  • Blurred vision

If your teen shows any of these less common lurasidone side effects, it’s important to reach out to your provider as soon as possible for advice and guidance. 

Lurasidone vs. Other Antipsychotics for Teens

In clinical terms, lurasidone has outperformed placebos (sugar pills) on the Positive and Negative Syndrome Scale (PANSS), which is used to measure improvements in schizophrenia. Its effectiveness in reducing the core symptoms of schizophrenia is also comparable to most other atypical antipsychotics. 

In fact, a study found it to be more effective than two other atypical antipsychotics, aripiprazole and ziprasidone, in reducing bipolar depression symptoms.8

Additionally, lurasidone may also have a significant edge when you factor in side effect burden and dropoff rates. One of the most difficult side effects to manage in antipsychotic treatment, especially for young people, is weight gain. Yet, in clinical experiments, teens taking lurasidone gained almost no additional weight compared to those not taking medication. 

To break it down further, compared to other commonly prescribed antipsychotics, Latuda led to 3.62kg less weight gain than olanzapine, 2.13kg less than quetiapine, and about 1kg less than risperidone, asenapine, and paliperidone.9  Therefore, if weight gain on antipsychotics is a concern for a teen, Latuda may be a valuable option.

Finally, all-cause discontinuation (which is stopping the drug for any reason) was significantly lower for Lurasidone compared to other drugs like aripiprazole and paliperidone.
Lurasidone and teen mental health

Get the Right Support for Teen Mental Health

Unfortunately, treating complex teen mental health conditions like schizophrenia or bipolar disorder is rarely as simple as just taking medication. Latuda is an excellent and well-tolerated option for treating symptoms, but it works best when paired with a strong support system that addresses the emotional, psychological, and social challenges involved. 

Adolescent mental health programs at Mission Prep provide sustained support and real, lasting change for teens. Using a clinical foundation built on recovery-oriented cognitive therapy (CT-R), we help teens identify and build on their strengths and set meaningful, personalized goals. 

We also combine CT-R with other evidence-based therapies like cognitive behavioral therapy, eye movement desensitization and reprocessing, and transcranial magnetic stimulation (TMS).

If you’re looking for compassionate, tailored support to complement medication, reach out to us today.

References

  1. HIGHLIGHTS OF PRESCRIBING INFORMATION. (n.d.). U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/200603lbls10s11.pdf
  2. Azhar, Y., & Shaban, K. (2023, June 12). Lurasidone. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK541057/
  3. Goldman, R., Loebel, A., Cucchiaro, J., Deng, L., & Findling, R. L. (2017). Efficacy and safety of lurasidone in adolescents with schizophrenia: A 6-week, randomized placebo-controlled study. Journal of Child and Adolescent Psychopharmacology, 27(6), 516–525. https://doi.org/10.1089/cap.2016.0189
  4. DelBello, M. P., Goldman, R., Phillips, D., Deng, L., Cucchiaro, J., & Loebel, A. (2017). Efficacy and safety of lurasidone in children and adolescents with bipolar I depression: A double-blind, placebo-controlled study. Journal of the American Academy of Child & Adolescent Psychiatry, 56(12), 1015–1025. https://doi.org/10.1016/j.jaac.2017.10.006
  5. Mole, T. B., Furlong, Y., Clarke, R. J., Rao, P., Moore, J. K., Pace, G., Van Odyck, H., & Chen, W. (2022). Lurasidone for adolescents with complex mental disorders: A case series. Journal of Pharmacy Practice, 35(5), 800–804. https://doi.org/10.1177/0897190021997011
  6. Channing, J., Mitchell, M., & Cortese, S. (2018). Lurasidone in children and adolescents: Systematic review and case report. Journal of Child and Adolescent Psychopharmacology, 28(7), 428–436. https://doi.org/10.1089/cap.2018.0046
  7. McClellan, L., Dominick, K. C., Pedapati, E. V., Wink, L. K., & Erickson, C. A. (2017). Lurasidone for the treatment of irritability and anger in autism spectrum disorders. Expert Opinion on Investigational Drugs, 26(8), 985–989. https://doi.org/10.1080/13543784.2017.1353600
  8. Ostacher, M., Ng-Mak, D., Patel, P., Ntais, D., Schlueter, M., & Loebel, A. (2017). Lurasidone compared to other atypical antipsychotic monotherapies for bipolar depression: A systematic review and network meta-analysis. The World Journal of Biological Psychiatry, 19(8), 586–601. https://doi.org/10.1080/15622975.2017.1285050
  9. Arango, C., Ng-Mak, D., Finn, E., Byrne, A., & Loebel, A. (2019). Lurasidone compared to other atypical antipsychotic monotherapies for adolescent schizophrenia: A systematic literature review and network meta-analysis. European Child & Adolescent Psychiatry, 29(9), 1195–1205. https://doi.org/10.1007/s00787-019-01425-2

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