Longer-Term Effectiveness and Tolerability of Adjunctive Open Lurasidone in Patients With Bipolar Disorder
| Autor: | Lauren Chang, Po W. Wang, Shefali Miller, Farnaz Hooshmand, Terence A. Ketter, Anda Gershon, Dennis Do |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Bipolar Disorder Time Factors Treatment outcome MEDLINE 03 medical and health sciences Lurasidone Hydrochloride Young Adult 0302 clinical medicine Medicine Humans Pharmacology (medical) In patient Bipolar disorder Young adult Lurasidone Retrospective Studies business.industry Retrospective cohort study Middle Aged medicine.disease 030227 psychiatry Psychiatry and Mental health Treatment Outcome Tolerability Female business 030217 neurology & neurosurgery medicine.drug Antipsychotic Agents |
| Zdroj: | Journal of clinical psychopharmacology. 38(3) |
| ISSN: | 1533-712X |
| Popis: | To retrospectively assess lurasidone effectiveness/efficacy/tolerability in bipolar disorder (BD) patients.Outpatients assessed with Systematic Treatment Enhancement Program for BD Affective Disorders Evaluation received naturalistically administered (primarily adjunctive) open lurasidone while monitored at visits with the Systematic Treatment Enhancement Program for BD Clinical Monitoring Form.Sixty-one patients (32 type I, 26 type II, 3 type not otherwise specified; mean ± SD age, 45.1 ± 14.0 years; 63.9% were female) received lurasidone with 3.1 ± 1.4 (≥2 in 88.5%, monotherapy in only 3.3%) other nonanxiolytic/hypnotic prescription psychotropics, started during syndromal depression in 57.4%, subsyndromal depression in 23.0%, and euthymia in 19.7%. Lurasidone was taken for median 126 days, with final dose 55.6 ± 30.8 mg/d. By final visit taking lurasidone, syndromal depression rate decreased by nearly one-half to 31.1%, and euthymia rate more than doubled to 42.6%, whereas subsyndromal depression rate was unchanged at 23.0%. Clinical Global Impressions-BD-Overall Severity improved significantly only in patients with baseline syndromal depression. Seventy-seven percent of patients discontinued lurasidone after median 103 days, because of adverse events in 54.1% (most often akathisia, sedation/somnolence, nausea, and weight gain), inefficacy in 16.4%, and other reasons in 6.6%; 12.1% had equal to or greater than 7% weight gain, and 3.3% developed hypomania. Limitations to this study were the open design and demographically homogeneous (relatively affluent, predominantly white female) small sample taking complex pharmacotherapy.In American specialty clinic BD outpatients, adjunctive longer-term lurasidone commonly relieved syndromal depression and maintained euthymia, suggesting possible effectiveness/efficacy. However, lurasidone was discontinued in 54.1% because of adverse events, suggesting tolerability limitations in these challenging patients, nearly 90% of whom were already taking at least 2 other nonanxiolytic/hypnotic prescription psychotropics. |
| Databáze: | OpenAIRE |
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