Patient Profiles

Help your patients with bipolar depression experience more of life's everyday moments.

*Not an actual patient. The Licensed Material is being used for illustrative purposes only. Any person depicted in the Licensed Material, if any, is a model.


Learn more about the types of patients in your practice that may be appropriate for treatment with LATUDA

Click on the patient's photos below to learn more about who they are and how they are currently dealing with their bipolar depression.

Overview
Lisa_lg

“When I feel depressed, I want to be alone. I’m afraid of being vulnerable in front of the world.”

  • Female, age 32
  • Stay-at-home mom
  • Married with 2 children
History
Lisa_lg

History

  • Diagnosed with postpartum depression following birth of her first child (10 years ago)
  • Diagnosed with major depressive episodes associated with bipolar I disorder 5 years ago, after an episode of postpartum psychosis following the birth of her second child
  • Comorbid conditions: anxiety, hypothyroidism, type 2 diabetes, BMI 26
  • Previous medications: antidepressant, mood stabilizer
  • Current medications: mood stabilizer, levothyroxine, metformin
Presentation
Lisa_lg

Presentation

  • Chief complaint: frequent depressive episodes, with premenstrual exacerbation
    • Husband reports patient is frequently withdrawn from friends and family and will isolate herself for days at a time
Overview
Craig_lg

"I don’t want to go anywhere, see anyone, or do anything.'"

  • Male, age 37
  • IT professional and part-time student
  • Living with fiancée
History
Craig_lg

History

  • Diagnosed with major depressive disorder (8 years ago)
  • Diagnosed with major depressive episodes associated with bipolar I disorder 3 years ago; previously hospitalized for manic episodes and related substance abuse
  • Comorbid conditions: hyperlipidemia and hypertension, BMI 33
  • Previous medications: multiple SSRIs, mood stabilizers
  • Current medications: patient reports he has stopped taking all medication (doesn't like the way it makes him feel)
Presentation
Craig_lg

Presentation

  • Brought to emergency department by fiancée after missing 4 consecutive days of work due to extreme fatigue and a disinterest in usual daily activities
  • Chief complaints: extreme feelings of worthlessness and inability to think and concentrate
    • Fiancée reports patient's behavior "has never been this bad"
Overview
Jimmy_lg

“It’s hard being down."

  • Male, age 28
  • War veteran
  • Married with 2 children
History
Jimmy_lg

History

  • Diagnosis of bipolar I disorder 6 years ago
  • Comorbid conditions: anxiety (controlled with medication) with a history of substance abuse
  • Previous medications: multiple antidepressants, mood stabilizers, antipsychotics, benzodiazepine
  • Current medications: patient reports that he has stopped taking medication
Presentation
Jimmy_lg

Presentation

  • Severe depressive symptoms led wife to bring him in to facility for evaluation
  • Chief complaints: doesn’t like the way medication makes him feel, isn’t able to concentrate at work
    • Wife complains he is aggravated and temperamental
Overview
Rosa_lg

“I don’t really want to talk about my condition. I feel fine.”

  • Female, age 35
  • Stay-at-home mom
  • Married with 3 children
History
Rosa_lg

History

  • Diagnosis of bipolar I disorder 6 months ago (had a previous manic episode)
  • Had been untreated/undiagnosed for years because she didn’t think she needed to see a doctor
  • Comorbid conditions: struggles with type 2 diabetes (controlled with medication), obesity, and insomnia
  • Previous medication: antipsychotic
  • Current medication: mood stabilizer
Presentation
Rosa_lg

Presentation

  • Due to continued depressive episodes, daughter and husband brought her to physician, which led to diagnosis
  • Chief complaint: worried about additional pill burden and side effects of a new therapy
    • Family is committed to helping Rosa with a healthier lifestyle
Overview
Jen_lg

"I feel so-so, but still feel disconnected; I'm not interested in my normal routine."

  • Female, age 42
  • Administrative assistant
  • Married
History
Jen_lg

History

  • Diagnosis of bipolar I disorder 2 years ago
  • Had a manic episode that raised concern from her husband that led to diagnosis (previous treatment with antidepressant therapy may have caused)
  • Comorbid conditions: anxiety (controlled with medication) with a history of substance abuse
  • Previous medications: different antipsychotics, SSRIs, mood stabilizers, antidepressants
  • Current medications: atypical antipsychotic with mood stabilizer
Presentation
Jen_lg

Presentation

  • Chief complaint: trouble communicating feelings and side effects of medications
    • Sister says she hasn't been the same since switching medication, notices lack of interest and lethargy in daily activities

Watch our clinical expert video series to learn more about diagnostic challenges in bipolar depression

Important Safety Information & Indications

INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS; AND SUICIDAL THOUGHTS AND BEHAVIORS 

CONTRAINDICATIONS
LATUDA is contraindicated in the following:

WARNINGS AND PRECAUTIONS
Cerebrovascular Adverse Reactions, Including Stroke: In placebo-controlled trials with risperidone, aripiprazole, and olanzapine in elderly subjects with dementia, there was a higher incidence of cerebrovascular adverse reactions (cerebrovascular accidents and transient ischemic attacks) including fatalities compared to placebo-treated subjects. LATUDA is not approved for the treatment of patients with dementia-related psychosis.

Neuroleptic Malignant Syndrome (NMS): NMS, a potentially fatal symptom complex, has been reported with administration of antipsychotic drugs, including LATUDA. NMS can cause hyperpyrexia, muscle rigidity, altered mental status and evidence of autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis, and cardiac dysrhythmia). Additional signs may include elevated creatine phosphokinase, myoglobinuria (rhabdomyolysis), and acute renal failure. Management should include immediate discontinuation of antipsychotic drugs and other drugs not essential to concurrent therapy, intensive symptomatic treatment and medical monitoring, and treatment of any concomitant serious medical problems.

Tardive Dyskinesia (TD): TD is a syndrome consisting of potentially irreversible, involuntary, dyskinetic movements that can develop in patients with antipsychotic drugs. There is no known treatment for established cases of TD, although the syndrome may remit, partially or completely, if antipsychotic treatment is withdrawn. The risk of developing TD and the likelihood that it will become irreversible are believed to increase as the duration of treatment and the total cumulative dose of antipsychotic drugs administered to the patient increase. However, the syndrome can develop, although much less commonly, after relatively brief treatment periods at low doses. Given these considerations, LATUDA should be prescribed in a manner that is most likely to minimize the occurrence of TD. If signs and symptoms appear in a patient on LATUDA, drug discontinuation should be considered.

Metabolic Changes

Hyperglycemia and Diabetes Mellitus: Hyperglycemia, in some cases extreme and associated with ketoacidosis or hyperosmolar coma or death, has been reported in patients treated with atypical antipsychotics. Patients with risk factors for diabetes mellitus (e.g., obesity, family history of diabetes) who are starting treatment with atypical antipsychotics should undergo fasting blood glucose testing at the beginning of and periodically during treatment. Any patient treated with atypical antipsychotics should be monitored for symptoms of hyperglycemia including polydipsia, polyuria, polyphagia, and weakness. Patients who develop symptoms of hyperglycemia during treatment with atypical antipsychotics should undergo fasting blood glucose testing.  In some cases, hyperglycemia has resolved when the atypical antipsychotic was discontinued; however, some patients required continuation of anti-diabetic treatment despite discontinuation of the suspect drug.

Dyslipidemia: Undesirable alterations in lipids have been observed in patients treated with atypical antipsychotics.

Weight Gain: Weight gain has been observed with atypical antipsychotic use. Clinical monitoring of weight is recommended.

Hyperprolactinemia: As with other drugs that antagonize dopamine D2 receptors, LATUDA elevates prolactin levels.  Galactorrhea, amenorrhea, gynecomastia, and impotence have been reported in patients receiving prolactin-elevating compounds.

Adult patients with bipolar depression:

In the short-term, placebo-controlled monotherapy study, the median change from baseline to endpoint in prolactin levels for LATUDA-treated females was 3.1 ng/mL and was 1.5 ng/mL for males.  The proportion of female patients with prolactin elevations ≥5x ULN was 0.6% for LATUDA-treated patients versus 0% for placebo-treated female patients. The proportion of male patients with prolactin elevations ≥5x ULN was 0% for LATUDA-treated patients versus 0% for placebo-treated male patients.In the short-term, placebo-controlled adjunctive therapy with lithium or valproate study, the median change from baseline to endpoint in prolactin levels for LATUDA-treated females was 3.2 ng/mL and was 2.4 ng/mL for males. The proportion of female patients with prolactin elevations ≥5x ULN was 0% for LATUDA-treated patients versus 0% for placebo-treated female patients. The proportion of male patients with prolactin elevations ≥5x ULN was 0% for LATUDA-treated patients versus 0% for placebo-treated male patients.

Adult patients with schizophrenia:

In the short-term, placebo-controlled studies, the median change from baseline to endpoint in prolactin levels for LATUDA-treated females was -0.2 ng/mL and was 0.5 ng/mL for males. The proportion of female patients with prolactin elevations ≥5x ULN was 5.7% for LATUDA-treated patients versus 2.0% for placebo-treated female patients. The proportion of male patients with prolactin elevations ≥5x ULN was 1.6% for LATUDA-treated patients versus 0.6% for placebo-treated male patients.

Leukopenia, Neutropenia, and Agranulocytosis: Leukopenia/neutropenia has been reported during treatment with antipsychotic agents. Agranulocytosis (including fatal cases) has been reported with other agents in the class. Patients with a preexisting low white blood cell count (WBC) or a history of drug-induced leukopenia/neutropenia should have their complete blood count (CBC) monitored frequently during the first few months of therapy, and LATUDA should be discontinued at the first sign of a decline in WBC in the absence of other causative factors.

Orthostatic Hypotension and Syncope: LATUDA may cause orthostatic hypotension. Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension, in patients with known cardiovascular disease or history of cerebrovascular disease and in patients who are antipsychotic-naїve.

Seizures: LATUDA should be used cautiously in patients with a history of seizures or with conditions that lower seizure threshold (e.g., Alzheimer’s dementia).

Potential for Cognitive and Motor Impairment: Patients should be cautioned about operating hazardous machinery, including motor vehicles, until they are reasonably certain that therapy with LATUDA does not affect them adversely.

Body Temperature Regulation: Disruption of the body’s ability to reduce core body temperature has been attributed to antipsychotic agents.  Appropriate care is advised when prescribing LATUDA for patients who will be experiencing conditions that may contribute to an elevation in core body temperature, e.g., exercising strenuously, exposure to extreme heat, receiving concomitant medication with anticholinergic activity, or being subject to dehydration.

Suicide: The possibility of suicide attempt is inherent in psychotic illness and close supervision of high-risk patients should accompany drug therapy. Prescriptions for LATUDA should be written for the smallest quantity of tablets consistent with good patient management in order to reduce the risk of overdose.

Dysphagia: Esophageal dysmotility and aspiration have been associated with antipsychotic drug use. Aspiration pneumonia is a common cause of morbidity and mortality in elderly patients, in particular those with advanced Alzheimer’s dementia. LATUDA and other antipsychotic drugs should be used cautiously in patients at risk for aspiration pneumonia.

ADVERSE REACTIONS
Commonly observed adverse reactions (≥5% incidence and at least twice the rate of placebo) for LATUDA:

Indications
LATUDA is indicated for:

Before prescribing LATUDA, please read the full Prescribing Information, including Boxed Warnings.