Open-Label Switch Study | Latuda® (lurasidone HCl) for SZ

Switch Data in Adult Patients

Switch Study Included 3 Dosing Strategies for Switching to LATUDA1

Latuda® (lurasidone HCI) - Adult Switch Study Design Chart

Clinical Study Design Overview

  • The efficacy of LATUDA was established in five 6-week, double-blind, placebo-controlled studies in adult patients with schizophrenia. This 6-week open-label study, which was not 1 of these 5 studies, was conducted to evaluate the effectiveness of switching adult patients with schizophrenia (N=244) to LATUDA from a variety of antipsychotics using 3 different dosing strategies1
  • 4 patients were randomized but exited the study before receiving LATUDA. In Week 1, the dose of the previous (switched-from) antipsychotic was maintained, and treatment with fixed daily doses of LATUDA (either 40 mg or 80 mg) was initiated. In Week 2, the dose of the previous antipsychotic was reduced by 50% and LATUDA dosage either maintained (40 mg/day → 40 mg/day and 80 mg/day → 80 mg/day) or increased (40 mg/day → 80 mg/day). All previous antipsychotics were discontinued completely at the end of Week 2, and patients were treated with flexible doses of LATUDA (40–120 mg/day) dosed in the evening within 30 minutes after eating1 
  • Primary outcome was time to treatment failure defined as: insufficient clinical response, exacerbation of underlying illness, or discontinuation due to an adverse event. Secondary outcomes included the following assessments: safety and tolerability, PANSS total score, and CGI-S score1
  • Study patients (safety population n=240) were switched from a variety of antipsychotic agents: quetiapine (25.8%); risperidone (21.3%); aripiprazole (18.3%); ziprasidone (11.3%); olanzapine (10.0%); paliperidone (3.8%); haloperidol (2.5%) perphenazine (1.7%); iloperidone (1.7%); fluphenazine (2.9%); chlorpromazine (1.3%); asenapine (0.8%); thiothixene (0.4%)1

The effect of LATUDA on safety parameters was evaluated and the safety profile was consistent with results from controlled 6-week studies in adult patients with schizophrenia.1

6-Week Switch Study in Adult Patients: Results

Open-label Switch Study in adult patients: More than 80% of patients completed treatment

Latuda® (lurasidone HCI) - Switch Study Completion Rate Chart

Latuda® (lurasidone HCI) - Switch Study Rates of Treatment Failure by Dosing Group Table

Adverse reactions with LATUDA in adult patients

Latuda® (lurasidone HCI) - Switch Study Adverse Reactions Table

Change in metabolic parameters in adult patients

Latuda® (lurasidone HCI) - Switch Study Change in Metabolic Parameters Chart

  • Weight gain has been observed with atypical antipsychotic use. Clinical monitoring of weight is recommended2
  • Undesirable alterations in lipids have been observed in patients treated with atypical antipsychotics2
  • Any patient treated with atypical antipsychotics should be monitored for symptoms of hyperglycemia including polydipsia, polyuria, polyphagia, and weakness2

Change in prolactin levels

  • Median change from baseline in prolactin through study endpoint for all patients after switching to LATUDA was 0.5 ng/mL (n=219)3

Symptom improvement in PANSS total scores in an open-label study in adult patients

Latuda® (lurasidone HCI) - Switch Study PANSS Total Score Chart

  • Results were similar regardless of switch strategy. Switch strategy may be based on individual need and clinical judgment1
  • Symptom improvement was seen over the course of the 6-week study1
    • In addition, LATUDA improved CGI-S scores, a secondary endpoint, at Week 6 (LS mean change −0.2 from baseline [LOCF]). Baseline CGI-S score for all patients receiving LATUDA (all subjects) was 3.7 (n=235)1

 McEvoy JP, Citrome L, Hernandez D, et al. Effectiveness of lurasidone in patients with schizophrenia or schizoaffective disorder switched from other antipsychotics: a randomized, 6-week, open-label study. J Clin Psychiatry. 2013;74(2):170-179.
2. Latuda® (lurasidone HCl) prescribing information. Sunovion Pharmaceuticals Inc. March 2018.
3. Data on file. Sunovion Pharmaceuticals Inc.



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 (


LATUDA is indicated for:

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