Latuda® (lurasidone HCl) Virtual Education Center | HCP Resources

Virtual Education Center

The Virtual Education Center is a hub for education and data about bipolar depression. From peer-delivered virtual seminars to in-depth patient profiles and case studies.

The Bipolar Depression Case Study Challenge

The Case Study Challenge delivers an interactive experience and provides an opportunity for you to interact and share insights with your peers on challenging patient cases and their symptoms. Dr. Stephen M. Stahl provides commentary and clinical insights to guide you along the way.

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Learn about bipolar depression

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See beyond patient symptoms

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Learn about a treatment option

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Learn about bipolar depression

Select a case study to take a deeper dive into one of the patient stories. Review the patient’s profile, hear peer perspective, and answer questions about the condition.

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Case 1: Kevin’s* Differential Diagnosis

What are some ways to screen a patient for bipolar depression since the depressive phase is similar to that of major depressive disorder? 

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Case 1: Kevin’s* Differential Diagnosis

Kevin is 31 and has been treated for major depressive disorder for approximately one year. Learn more by reviewing the profile and answering questions.

1

Based on this information, which of the following statements is most accurate?


A

I believe the original diagnosis is correct.

B

I’m not sure the original diagnosis is correct for Kevin.

C

I believe Kevin may have bipolar I disorder and would screen accordingly.

You are correct!

Here’s why: While the diagnostic criteria are identical for major depressive disorder, bipolar I and bipolar II disorder1, there are differences. Manic episodes, which Kevin displayed when he admitted to making spontaneous purchase, could indicate bipolar I disorder and should lead you to screen Kevin.

The correct answer is C

Here’s why: The diagnostic criteria for a DSM-5 major depressive episode are identical for MDD, bipolar I and bipolar II disorder.1 Two-thirds of patients with bipolar disorder are misdiagnosed, with the most frequent misdiagnosis (60%) being unipolar depression.2 Screening is crucial. 

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

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Publishing; 2013.
2. Hirschfeld RMA, Lewis L, Vornik LA. Perceptions and impact of bipolar disorder: how far have we really come? Results of the National Depressive and Manic-Depressive Association 2000 survey of individuals with bipolar disorder. J Clin Psychiatry. 2003;64:161-174.

2

In this case, Kevin has an initial diagnosis of major depressive disorder. If you suspect a patient who has been diagnosed with unipolar depression may have bipolar depression, what is your first move?


A

Employ a screening tool, like the Mood Disorder Questionnaire

B

Re-review the patient history and interview the patient further to see if you identify a past manic episode

C

Request to talk to family members (such as a parent or spouse) to get information from a third party close to the patient

D

None of the above

This is really a question of preference and treatment for each physician. There are several ways that you can screen for bipolar depression. 

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

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Publishing; 2013.
2. Hirschfeld RMA, Lewis L, Vornik LA. Perceptions and impact of bipolar disorder: how far have we really come? Results of the National Depressive and Manic-Depressive Association 2000 survey of individuals with bipolar disorder. J Clin Psychiatry. 2003;64:161-174.

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Case 2: Wendy’s* Breakthrough Symptoms

Do breakthrough symptoms indicate that it is time to consider a change in treatment approach?

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Case 2: Wendy’s* Breakthrough Symptoms

Wendy is a 29-year-old stay-at-home mom who was diagnosed with major depressive episodes associated with bipolar I disorder 8 years ago. Learn more by reviewing the profile and answering questions.

1

Based on this information, which of the following statements is the most accurate?


A

I believe this is an episode, and she should stay the course.

B

I believe Wendy needs to be re-evaluated and perhaps her medications need to be adjusted.

C

I’m not sure that Wendy has major depressive disorder.

You are correct!

Here’s why: Even with mood-stabilizing treatment, patients, like Wendy, with bipolar disorder spend about 40% to 50% of the year symptomatic.1 And up to 75% of that time is spent in a depressed state.1 Patients should be re-evaluated on a regular basis, as bipolar depression is a life-long illness.

The correct answer is B

Here’s why: Bipolar depression is a life-long illness that needs constant evaluation and re-evaluation. Even with mood-stabilizing treatment, patients, with bipolar disorder spend about 40% to 50% of the year symptomatic.1 And up to 75% of that time is spent in a depressed state.1

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

Reference:
1. Baldessarini RJ, Vieta E, Calabrese JR, et al. Bipolar depression: overview and commentary. Harv Rev Psych. 2010;18:143-157.

2

What is the first thing that comes to mind when you consider adding a medication to a mood stabilizer in a patient with bipolar depression?


A

The adverse event profile of the drug and the patient’s physical health profile

B

The potential for adequate symptom control in a patient who needs another treatment option 

C

My personal experience prescribing the drug for other patients

D

None of the above

This is really a question of preference and treatment for each physician. There are many considerations that come into play in this instance.

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Reference:

1. Baldessarini RJ, Vieta E, Calabrese JR, et al. Bipolar depression: overview and commentary. Harv Rev Psych. 2010;18:143-157.

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Case 3: Peter’s* Adverse Events

When is it time to change course if a patient doesn’t take his medication due to adverse events?

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Case 3: Peter’s* Adverse Events

Peter is a 42-year-old patient who owns his own business. He was recently referred to a colleague as his previous physician retired. He’s frustrated with his medication, which he says is “more trouble than it’s worth.” Learn more by reviewing the profile and answering questions. 

1

Based on this information, which of the following statements is the most accurate?


A

I need to get to know Peter and his condition more before I can determine the best course of action.

B

I need to consider a change of treatment given his reactions and his adverse reactions.

C

I need to focus on his metabolic issues, given his family history. 

You are correct!

Here’s whyMonitoring patients involves making sure a therapy achieves the right balance of symptom control and tolerability. More discussions with Peter will give you the information you need.

The correct answer is A

Here’s why: Adherence can become an issue in some patients. And monitoring patients, and getting to know them, involves making sure a therapy achieves the right balance of symptom control and tolerability.

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

2

What would be your most pressing concern about Peter’s mental or physical health?


A

His nonadherence could cause symptoms of mania to re-emerge (risky financial behavior)

B

Worsening of depressive symptoms (feelings of worthlessness, depressed mood)

C

His weight gain and risk of metabolic syndrome and/or cardiovascular disease

D

None of the above

This is really a question of preference and treatment for each physician. Peter has many issues and challenges that need to be addressed.

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

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Case 4: Kristin’s* Mood Symptoms

When symptoms are not well managed in a patient with bipolar depression, do you supplement treatment with patient education or change course?

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Case 4: Kristin’s* Mood Symptoms

Kristin is a 28-year-old hotel chef who was diagnosed with bipolar depression 6 months ago. She struggles with her treatment and the side effects. Learn more by reviewing the profile and answering questions.  

1

Based on this information, which of the following statements is the most accurate?


A

Speaking with Kristin will give me a better indication about her adherence, her struggles, and ultimately the effectiveness of her treatment. 

B

I need to adjust her medications to better control her condition.

C

I need to re-evaluate Kristin’s diagnosis.

You are correct!

Here’s whyTreatment may not always manage symptoms properly. Monitoring a patient over time for changes in mood while receiving treatment is critical.1 From small changes in mood that may indicate the onset of an episode to ongoing symptoms or breakthrough episodes, a change in therapy may be required. Speaking with Kristin will give you an opportunity to address a change in therapy.

The correct answer is A

Here’s whyMonitoring a patient over time for changes in mood while receiving treatment is critical.1 From small changes in mood which may indicate the onset of an episode to ongoing symptoms or breakthrough episodes may require a change in therapy. Speaking with Kristin will give you that opportunity.

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

Reference:
1. Hirschfeld RMA, Bowden MJ, Keck PE, et al. Practice guideline for the treatment of patients with bipolar disorder: second edition. 2010; American Psychiatric Association.

2

What might you discuss first with a patient like Kristin?


A

The symptoms of bipolar depression and the psychosocial stressors that might trigger major depressive episodes

B

Provide education about the importance of a regular daily schedule and the risk of disrupted sleep-wake cycles

C

Her continued symptoms and the possibility that her treatment course may need to be changed

D

None of the above

This is really a question of preference and treatment for each physician. Kristin faces some significant challenges but open dialogue is important. Speaking with Kristin will give you an opportunity to address a change in therapy.

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

Reference:
1. Hirschfeld RMA, Bowden MJ, Keck PE, et al. Practice guideline for the treatment of patients with bipolar disorder: second edition. 2010; American Psychiatric Association.

 

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

The clinical commentary provided in this video reflects the views of an actual licensed clinician, who has been engaged by Sunovion to provide his insight. 

The information contained herein is intended for general information purposes only, and is not a substitute for your professional medical advice and judgment.

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2

See beyond patient symptoms

Select a case study to take a deeper dive into one of the patient stories. Review the patient’s profile, hear peer perspective, and answer questions about the condition.

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Case 1: The delay in diagnosing Nora*

Is it major depressive disorder or bipolar depression? Correct diagnosis can be delayed several years.

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Case 1: The delay in diagnosing Nora*

Nora is 29 years old, married, and a mother of a toddler. She was recently fired from her job as a sales rep at a tech company. She was diagnosed 9 years ago with major depressive disorder. Learn more by reviewing the profile and answering questions.  

1

Based on this information, which of the following statements is the most accurate?


A

Nora has been diagnosed correctly and may need an adjustment to her treatment.

B

Nora has been misdiagnosed with major depressive disorder.

C

Nora needs to be screened for bipolar depression, as her episodes of mania prove she may have been misdiagnosed. 

You are correct!

Here’s whyMany patients with bipolar disorder are first misdiagnosed with unipolar depression.1 And patients with bipolar disorder spend most of their symptomatic time in the depressed phase.2 Screening may help identify episodes of mania that were previously missed, as was the case in Nora.

The correct answer is C

Here’s whyMany patients with bipolar disorder are first misdiagnosed with unipolar depression.1 And patients with bipolar disorder spend most of their symptomatic time in the depressed phase.2 Screening may help identify episodes of mania that were previously missed.

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

References:
1. Hirschfeld RM, Lewis L, Vornik LA. Perceptions and impact of bipolar disorder: how far have we really come? Results of the National Depressive and Manic-Depressive Association 2000 survey of individuals with bipolar disorder. J Clin Psychiatry. 2003;64(2):161-174.

2. Judd LL, Akiskal HS, Schettler PJ, et al. The long-term natural history of the weekly symptomatic status of bipolar I disorder. Arch Gen Psychiatry. 2002;59(6):530-537.

2

The DSM-5 diagnostic criteria for a manic episode adds “persistently increased goal-directed activity or energy” to changes in mood. With a patient like Nora, does this impact how you screen for bipolar disorder?


A

Yes, I look more actively for episodes of increased energy and activity.

B

Yes, but I still consider changes in energy level secondary to changes in mood.

C

No, because I have always taken persistently increased energy and activity into account when screening.

D

None of the above.

This is really a question of preference and treatment for each physician. What’s more important is evaluating her treatment and the response to it. 

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

References:
1. Hirschfeld RM, Lewis L, Vornik LA. Perceptions and impact of bipolar disorder: how far have we really come? Results of the National Depressive and Manic-Depressive Association 2000 survey of individuals with bipolar disorder. J Clin Psychiatry. 2003;64(2):161-174.

2. Judd LL, Akiskal HS, Schettler PJ, et al. The long-term natural history of the weekly symptomatic status of bipolar I disorder. Arch Gen Psychiatry. 2002;59(6):530-537.

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Case 2: Mark’s* symptoms over time

The management of patients with bipolar depression can be challenging as they often persist for years.

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Case 2: Mark’s* symptoms over time

Mark is a 33-year-old patient who works at a local bank. He has challenges with his health beyond his bipolar I disorder, which he was diagnosed with 6 years ago. Learn more by reviewing the profile and answering questions.  

1

Based on this information, which of the following statements is the most accurate?


A

Mark needs to get his substance abuse under control before I can really help him.

B

Mark’s weight gain, confusion, and family history are troubling, but also common in patients with bipolar I disorder.

C

I need to get to the bottom of Mark’s adherence issues.

You are correct!

Here’s whyMark’s weight gain and history play an important role in his assessment.1 These challenges, along with comorbid medical illnesses, are frequently seen with bipolar disorder and can complicate both diagnosis and treatment. 2,3

The correct answer is B

Here’s whyComorbid medical illnesses and substance abuse, along with weight and confusion, are frequently seen with bipolar disorder and can complicate diagnosis and treatment.2,3

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

References:
1. Simon NM, et al. Pharmacotherapy for bipolar disorder and comorbid conditions: baseline data from STEP-BD. J Clin Psychopharmacol. 2004;24(5):512-520.
2. Goldstein BI, et al. Cardiovascular disease and hypertension among adults with bipolar I disorder in the United States. Bipolar Disord. 2009;11(6):657-662.
3. de Almeida KM, et al. Metabolic syndrome and bipolar disorder: what should psychiatrists know? CNS Neurosci Ther. 2012;18(2):160-166.

2

If Mark were your patient, which of these issues would be a priority?


A

Improving his persistent depressed mood

B

Tackling his substance abuse

C

Checking in with his PCP to coordinate care regarding his other medications and reported occasional confusion and nonadherence

D

None of the above

This is really a question of preference and treatment for each physician. With Mark, there are a multitude of challenges, just getting started is going to help.    

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

References:
1. Simon NM, et al. Pharmacotherapy for bipolar disorder and comorbid conditions: baseline data from STEP-BD. J Clin Psychopharmacol. 2004;24(5):512-520.
2. Goldstein BI, et al. Cardiovascular disease and hypertension among adults with bipolar I disorder in the United States. Bipolar Disord. 2009;11(6):657-662.
3. de Almeida KM, et al. Metabolic syndrome and bipolar disorder: what should psychiatrists know? CNS Neurosci Ther. 2012;18(2):160-166.

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

The clinical commentary provided in this video reflects the views of an actual licensed clinician, who has been engaged by Sunovion to provide his insight. 

The information contained herein is intended for general information purposes only, and is not a substitute for your professional medical advice and judgment.

TRACK

3

Learn about a treatment option

Select a case study to take a deeper dive into one of the patient stories. Review the patient’s profile, hear peer perspective, and answer questions about the condition.

Completion Check Mark

Case 1: Rick’s* comorbid anxiety

Treating your patient with comorbid anxiety is all about balancing benefits and risks.

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Case 1: Rick’s* comorbid anxiety

Rick is a 31-year-old manager of a retail store. He has struggled with depressive symptoms since he was 17, when he made an attempt at suicide. Learn more by reviewing the profile and answering questions. 

1

Based on this information, which of the following statements is the most accurate?


A

Rick’s symptoms seem to confirm the diagnosis of bipolar I disorder, but I need more information to determine a treatment.

B

Rick may have bipolar depression and could benefit from an atypical antipsychotic.

C

I need to get a better handle on Rick’s adherence and symptoms before I consider a change of any kind.

You are correct!

Here’s whyWith Rick’s history and diagnosis of bipolar I disorder, as well as his current diagnosis of bipolar depression, he could benefit from an atypical antipsychotic, like LATUDA. Latuda® (lurasidone HCl) provides proven antidepressant efficacy in patients with bipolar depression.1 Efficacy and safety established in both a monotherapy study and an adjunctive therapy study with lithium or valproate in adults.1

The correct answer is B

Here’s whyWith Rick’s history and diagnosis of bipolar I disorder, as well as his current diagnosis of bipolar depression, he could benefit from an atypical antipsychotic, like LATUDA. Latuda® (lurasidone HCl) provides proven antidepressant efficacy in patients with bipolar depression.1 Efficacy and safety established in both a monotherapy study and an adjunctive therapy study with lithium or valproate in adults.1

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

Reference:
1. Latuda® (lurasidone HCl) prescribing information. Sunovion Pharmaceuticals Inc. March 2018.

2

Which of these nonpharmacologic tactics would you consider first if you were treating a patient like Rick?


A

Provide a chart for the patient to record changes in mood

B

Eliminate caffeine, improve diet, increase excercise

C

Make sleep a priority, with a consistent routine

D

None of the above

There really is no wrong answer here. This is a question of preference and treatment for each physician. Mood monitoring, dietary changes, and sleep are all important first steps to treat Rick.

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

Reference:
1. Latuda® (lurasidone HCl) prescribing information. Sunovion Pharmaceuticals Inc. March 2018.

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Case 2: Michelle’s* depression

What do you do when an SSRI induces a manic episode while your patient is hospitalized?

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Case 2: Michelle’s* depression

Michelle is a 30-year-old, divorced patient who is struggling with her depression. She’s unemployed and feels guilty needing to move in with her sister.  Learn more by reviewing the profile and answering questions.  

1

Based on this information, which of the following statements is the most accurate?


A

Michelle’s depressive symptoms don’t really indicate bipolar disorder.

B

I would continue to evaluate Michelle to see if the manic episode is atypical before making a change.

C

I would prescribe an atypical antipsychotic for Michelle, as her depressive symptoms are indicative of bipolar depression and a change is required.

You are correct!

Here’s whyFor Michelle, her depressive symptoms and past manic episode indicate bipolar depression. The best course of action is prescribing an atypical antipsychotic. Latuda® (lurasidone HCl) is an atypical antipsychotic that provides proven antidepressant efficacy in patients with bipolar depression.1 Efficacy and safety were established in both a monotherapy study and an adjunctive therapy study with lithium or valproate in adults.1

The correct answer is C

Here’s whyFor Michelle, her depressive symptoms and past manic episode indicate bipolar depression. The best course of action is prescribing an atypical antipsychotic. Latuda® (lurasidone HCl) is an atypical antipsychotic that provides proven antidepressant efficacy in patients with bipolar depression.1 Efficacy and safety were established in both a monotherapy study and an adjunctive therapy study with lithium or valproatein adults.1

NEXT QUESTION

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

Reference:
1. Latuda® (lurasidone HCl) prescribing information. Sunovion Pharmaceuticals Inc. March 2018.

2

If you have a patient who is diagnosed with unipolar depression and experiences treatment-induced mania, what would be your next step?


A

I would interview family members to see if any past manic episodes are identified and conduct a new detailed clinical evaluation.

B

I would evaluate further using a screener for mania, like the the Mood Disorder Questionnaire.

C

Mania that emerges during antidepressant treatment is sufficient evidence for a manic episode and may lead me to diagnose bipolar disorder.

D

I would reevaluate her medication, as many patients cycle through various treatments prior to landing on the correct therapy.

There really is no wrong answer here. Evaluating Michelle through family interviews, using a screening tool like the MDQ, diagnosing bipolar disorder, and reevaluating her treatment are all sound medical approaches. This is a question of preference and treatment for each physician.

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

Reference:
1. Latuda® (lurasidone HCl) prescribing information. Sunovion Pharmaceuticals Inc. March 2018.

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Case 3: Jordan’s* hospitalization

What course of action is appropriate when your patient is hospitalized with unresolved depressive symptoms?

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Case 3: Jordan’s* hospitalization

Jordan is a 50-year-old unemployed mechanic who was diagnosed with bipolar I disorder 11 years ago. Not currently on treatment, he’s struggling with addiction as well as depression. Learn more by reviewing the profile and answering questions.

1

Based on this information, which of the following statements is the most accurate?


A

Jordan’s unresolved depressive symptoms and failed treatments indicate a need for an atypical antipsychotic.

B

Jordan’s lack of successful treatment regimens lead me to believe I need to reevaluate him.

C

Jordan’s addiction is a serious concern that I feel needs my attention first.

You are correct!

Here’s whyA new treatment like an atypical antipsychotic is the most appropriate in Jordan’s case. One with proven efficacy in treating the symptoms of bipolar depression. Latuda® (lurasidone HCl) provides proven antidepressant efficacy in patients with bipolar depression.1 Efficacy and safety established in both a monotherapy study and an adjunctive therapy study with lithium or valproate in adults.1

The correct answer is A

Here’s whyA new treatment like an atypical antipsychotic is the most appropriate in Jordan’s case. One with proven efficacy in treating the symptoms of bipolar depression. Latuda® (lurasidone HCl) provides proven antidepressant efficacy in patients with bipolar depression.1 Efficacy and safety established in both a monotherapy study and an adjunctive therapy study with lithium or valproate in adults.1

NEXT QUESTION

Hear from Dr. Stahl

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

Reference:
1.
Latuda® (lurasidone HCl) prescribing information. Sunovion Pharmaceuticals Inc. March 2018.

2

How many trials of classic antidepressants would you try before considering another class of therapy for a patient with bipolar depression?


A

One

B

Two

C

Three or more  

D

I would try another approach altogether

There really is no wrong answer here. When cycling through treatment options, it may be appropriate to consider an atypical antipsychotic. Latuda® (lurasidone HCl) provides proven antidepressant efficacy in patients with bipolar depression.1 This is a question of preference and treatment for each physician.

NEXT QUESTION

Hear from Dr. Stahl

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

Reference:
1.
Latuda® (lurasidone HCl) prescribing information. Sunovion Pharmaceuticals Inc. March 2018.

Completion Check Mark

Case 4: Julie’s* new diagnosis

Your patient is experiencing irritability as she faces her new diagnosis of bipolar depression and new treatment.

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Case 4: Julie’s* new diagnosis

Julie is  a 25-year-old single patient who still lives with her parents. She is newly diagnosed and is dealing with metabolic issues. Learn more by reviewing the profile and answering questions.  

1

Based on this information, which of the following statements is the most accurate?


A

Julie is facing a multitude of issues, which should take precedence before transitioning her to an atypical antipsychotic.

B

Julie presents with all of the signs, from depressive symptoms to manic history, of bipolar depression, and an atypical antipsychotic would be my first choice for treatment.

C

Given her history and additional challenges, I believe an SSRI should be the first course of treatment.

You are correct!

Here’s whyJulie’s new diagnosis of bipolar depression requires an atypical antipsychotic like LATUDA. Latuda® (lurasidone HCl) provides proven antidepressant efficacy in patients with bipolar depression.1 Efficacy and safety established in both a monotherapy study and an adjunctive therapy study with lithium or valproate in adults.1

The correct answer is B

Here’s whyJulie’s new diagnosis of bipolar depression requires an atypical antipsychotic like LATUDA. Latuda® (lurasidone HCl) provides proven antidepressant efficacy in patients with bipolar depression.1 Efficacy and safety established in both a monotherapy study and an adjunctive therapy study with lithium or valproate in adults.1

NEXT QUESTION

Hear from Dr. Stahl

NEXT QUESTION

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

Reference:
1. Latuda® (lurasidone HCl) prescribing information. Sunovion Pharmaceuticals Inc. March 2018.

2

What would you consider first when thinking about treatment for a patient like Julie?


A

An SSRI or SNRI monotherapy

B

An anxiolytic or mood stabilizer (lithium or valproate) monotherapy

C

An atypical antipsychotic indicated for bipolar depression monotherapy

D

None of the above

There really is no wrong answer here. Each treatment regimen requires careful monitoring and evaluation. This is a question of preference and treatment for each physician.

NEXT QUESTION

Hear from Dr. Stahl

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

Reference:
1. Latuda® (lurasidone HCl) prescribing information. Sunovion Pharmaceuticals Inc. March 2018.

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

The clinical commentary provided in this video reflects the views of an actual licensed clinician, who has been engaged by Sunovion to provide his insight. 

The information contained herein is intended for general information purposes only, and is not a substitute for your professional medical advice and judgment.


 

Katie’s Story–with insights from Dr. Kiki Chang

Treating pediatric patients with bipolar depression requires insight and dialogue.

Chapter 1: Depressive Symptoms Emerge in a Pediatric Patient

Chapter 2: Irritability and Grandiose Claims in a Pediatric Patient

Chapter 3: Making a Diagnosis of Bipolar Depression in a Pediatric Patient

Chapter 4: Managing Pediatric Bipolar Depression

Chapter 1: Depressive Symptoms Emerge in a Pediatric Patient

Chapter 2: Irritability and Grandiose Claims in a Pediatric Patient

Chapter 3: Making a Diagnosis of Bipolar Depression in a Pediatric Patient

Chapter 4: Managing Pediatric Bipolar Depression

Mark’s Story–with clinical perspectives from Dr. Stephen M. Stahl

Dr. Stephen Stahl shares his insights into Mark who was diagnosed with bipolar depression.

Breakthrough Symptoms

Treatment Challenges

Collaborative Care

Breakthrough Symptoms

Treatment Challenges

Collaborative Care

Nora’s Story–with commentary provided by Dr. Stephen M. Stahl

Dr. Stephen Stahl share his insights into Nora’s misdiagnosis and eventual correct diagnosis.

Misdiagnosis

Suspected Bipolar Depression

Diagnosing Bipolar Depression

Misdiagnosis

Suspected Bipolar Depression

Diagnosing Bipolar Depression

Nurse Practitioners Perspectives with Tammy LeBlanc

NP Tammy LeBlanc shares her insights and discusses collaborative care for patients with bipolar depression

Is it Bipolar Disorder?

Collaborative Care from the NP Perspective

Is it Bipolar Disorder?

Collaborative Care from the NP Perspective

Featured experts are paid consultants of Sunovion.

Featured Newsletters

These newsletters provide expert perspectives on bipolar depression and LATUDA in adult patients.

VEC-Newsletter

Bipolar Depression: The Search for Diagnosis and Treatment

Susan J. Barnes, APRN-BC
Diane M. Snow, PhD, APRN, PMHNP-BC, FAANP, FIANN

VEC-Newsletter

Engaging Patients to Support Adherence

Vivien K Burt, MD, PhD
Catherine R. Judd, MS, PA-C, CAQ-Psychiatry, DFAAPA
Muricio Tohen, MD, DrPH, MBA

 

VEC-Newsletter

Bipolar Depression Diagnosis: Confounding Factors

Anna M. O’Kinsky, MSN, APN
Diane M. Snow, PhD, APRN, PMHNP-BC, FAANP, FIANN

VEC-Newsletter

Bipolar Depression: A Collaborative Approach to Care

Danielle L. Kamine, MS, ARNP, ANP-BC, CARN-AP, PMHNP-BC
Diane M. Snow, PhD, APRN, PMHNP-BC, FAANP, FIANN

VEC-Newsletter

Are You Up to Date? Latest Guidance for Evidence-Based Treatment for Adults with Bipolar Depression

William Clay Jackson, MD, DipTH, FAAFP
Susan L. Kraus, MSN, MAgS, CRNP-A, CRNP-PMH
Henry A. Nasrallah, MD

 

VEC-Newsletter

Managing Multiple Comorbidities in Bipolar Disorder

Larry Culpeppers, MD, MPH
Andrew J. Cutler, MD
James Sloan Manning, MD
Anna M. O’Kinsky, MSN, APN

 

VEC-Newsletter

Bipolar Depression Diagnosis: Confounding Factors

Vivien K Burt, MD, PhD
Henry A. Nasrallah, MD

 

 

VEC-Newsletter

Are You Up to Date? Latest Guidance for Evidence-Based Treatment for Adults with Bipolar Depression

William Clay Jackson, MD, DipTH, FAAFP
Susan L. Kraus, MSN, MAgS, CRNP-A, CRNP-PMH
Henry A. Nasrallah, MD

 

VEC-Newsletter

Engaging Patients to Support Adherence

Vivien K. Burt, MD, PhD
Catherine Judd, MS, PA-C, CAQ-Psychaitry, DFAAPA
Mauricio Tohen, MD, DrPH, MBA

VEC-Newsletter

Are You Up to Date? Latest Guidance for Evidence-Based Treatment for Adults with Bipolar Depression

William Clay Jackson, MD, DipTH, FAAFP
Susan L. Kraus, MSN, MAgS, CRNP-A, CRNP-PMH
Henry A. Nasrallah, MD

 

VEC-Newsletter

Bipolar Depression in Primary Care: A Collaborative Approach

William Clay Jackson, MD, DipTH, FAAFP
Henry A. Nasrallah, MD

 

 

VEC-Newsletter

Managing Multiple Comorbidities in Bipolar Disorder

Larry Culpeppers, MD, MPH
Andrew J. Cutler, MD
James Sloan Manning, MD
Anna M. O’Kinsky, MSN, APN

 

VEC-Newsletter

Engaging Patients to Support Adherence

Vivien K. Burt, MD, PhD
Catherine Judd, MS, PA-C, CAQ-Psychaitry, DFAAPA
Mauricio Tohen, MD, DrPH, MBA

Conferences

Psych Congress
October 3-6, 2019
San Diego, California

Neuroscience Education Institute
November 7-10, 2019
Colorado Springs, CO

American Psychiatric Association
April 25-29, 2020
Philadelphia, PA

 


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Learn About LATUDA

Review efficacy and safety in adjunctive in adults and monotherapy in adults and peds.

IMPORTANT SAFETY INFORMATION AND INDICATIONS FOR LATUDA

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

Increased Mortality in Elderly Patients with Dementia-Related Psychosis
Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. LATUDA is not approved for the treatment of patients with dementia-related psychosis.

Suicidal Thoughts and Behaviors
Antidepressants increased the risk of suicidal thoughts and behavior in pediatric and young adults in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors.

 

CONTRAINDICATIONS: LATUDA is contraindicated in the following:

Cerebrovascular Adverse Reactions, Including Stroke: In clinical trials, elderly subjects with dementia randomized to risperidone, aripiprazole, and olanzapine had a higher incidence of stroke and transient ischemic attack, including fatal stroke. LATUDA is not approved for the treatment of patients with dementia-related psychosis.

Neuroleptic Malignant Syndrome (NMS): NMS is a potentially fatal symptom complex reported with administration of antipsychotic drugs. Clinical signs of NMS are hyperpyrexia, muscle rigidity, altered mental status, and evidence of autonomic instability. Additional signs may include elevated creatine phosphokinase, myoglobinuria (rhabdomyolysis), and acute renal failure. Manage NMS with immediate discontinuation of antipsychotic drugs, including LATUDA, intensive symptomatic treatment and monitoring.

Tardive Dyskinesia (TD): The risk of developing TD (a syndrome of abnormal involuntary movements) and the potential for it to become irreversible are believed to increase as the duration of treatment and total cumulative dose of antipsychotic increase. The syndrome can develop, although much less commonly, after relatively brief treatment periods at low doses or may even arise after discontinuation of treatment. The syndrome may remit, partially or completely, if antipsychotic treatment is withdrawn.

Metabolic Changes Atypical antipsychotic drugs have caused metabolic changes including:

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 diabetes should be regularly monitored for worsening of glucose control; those with risk factors for diabetes 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 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.

Leukopenia, Neutropenia, and Agranulocytosis: Leukopenia/neutropenia has been reported with antipsychotics. Agranulocytosis (including fatal cases) has been reported with other agents in the class. Monitor complete blood count in patients with a pre-existing low white blood cell count (WBC)/absolute neutrophil count (ANC) or history of drug-induced leukopenia/neutropenia. Discontinue LATUDA at the first sign of a decline in WBC in the absence of other causative factors.

Orthostatic Hypotension and Syncope: Atypical antipsychotics cause orthostatic hypotension and syncope. Generally, the risk is greatest at the beginning of treatment and when increasing the dose. Monitor patients vulnerable to hypotension and those with cardiovascular and cerebrovascular disease.

Falls: Antipsychotics may cause somnolence, postural hypotension, or motor and sensory instability, which may lead to falls, causing fractures or other injuries. For patients with disease, conditions, or medications that could exacerbate these effects, complete fall risk assessments when initiating treatment and recurrently during therapy.

Seizures: LATUDA should be used cautiously in patients with a history of seizures or with conditions that lower seizure threshold.

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: Use LATUDA with caution in patients who may experience conditions that increase body temperature (e.g., exercising strenuously, exposure to extreme heat, concomitant medication with anticholinergic activity, or being subject to dehydration).

Dysphagia: Antipsychotics, including LATUDA, have been associated with esophageal dysmotility and aspiration, and should be used with caution in patients at risk for aspiration pneumonia.

Most Commonly Observed Adverse Reactions: Commonly observed adverse reactions (≥5% incidence and at least twice the rate of placebo) for LATUDA:

To report SUSPECTED ADVERSE REACTIONS, contact Sunovion Pharmaceuticals Inc. at 877-737-7226 or FDA at 1-800-FDA-1088 (www.fda.gov/medwatch).

Indications

LATUDA is indicated for:

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