In different periods of schizophrenia, the dosage of lurasidone is so different?

People who benefit from lurasidone

People who benefit from lurasidone can Includes: acute schizophrenic patients; maintenance treatment schizophrenic patients; schizophrenic patients with affective symptoms; Schizophrenic patients with cognitive impairment/high demand for cognitive function; patients with schizophrenia who are more concerned about body weight and prolactin levels.


Medication advice for first-time patients

< p data-track="5">First-episode patients are relatively sensitive to treatment, and the drug response is relatively good. On the other hand, first-episode patients are also relatively sensitive to adverse reactions. It is recommended to have a dose titration process. It is recommended to start at 40mg/d. If the patient has no adverse reactions such as extrapyramidal reaction (EPS), nausea, drowsiness within a week, the dose can be maintained according to the clinical efficacy of the patient treatment, or increase to 80 mg/d in the second week of treatment.

40 ~ 80 mg /d usually sufficient effect in first-episode patients, 80 mg/d is more effective than 40mg /d as obvious. For some patients with insufficient remission of 80 mg/d treatment, some patients in Taiwan can increase to 120 mg/d, and a few need to increase to 160 mg/d to obtain further symptom improvement.


Medicine recommendations for acute patients

Previous studies have shown that in the acute phase of treatment, compared with placebo, lurasidone at a dose of 40-160mg/d can effectively improve the psychotic symptoms of patients.

For patients in the acute stage, the current target dose in mainland China is believed to be increased to 80 mg/d, with an average dose of about 60-80 mg/d. However, when some patients still have no obvious relief after taking 80mg/d lurasidone, the patients can be asked about the way of taking the medicine to ensure the bioavailability of lurasidone by taking it with meals.

Acute phase with multiple episodes Compared with first-episode patients, patients with schizophrenia have better tolerance, and can appropriately speed up the titration to reduce the adverse effects of acute symptoms on patients.

Experts recommend starting with lurasidone 40mg/d, and after 2-3 days of use, the dose can be increased to 80mg/d after assessing that the patient has no adverse reactions. Patients with severe symptoms can be combined with other drugs with strong sedative effect, such as haloperidol injection, etc. for a short period of time.

Medicine recommendations for maintenance patients

Lurasidone has a positive effect on patients in the maintenance period, and has little effect on prolactin levels and body weight, so it is suitable for the maintenance period Treatment.

ResearchThe study showed that the risk of relapse in 28 weeks of patients treated with 40-80 mg /d lurasidone for maintenance treatment was significantly lower than that of the placebo group.

For patients with clear efficacy of lurasidone in the acute phase, it is recommended to continue using lurasidone in the maintenance phase; For the acute phase For patients who have not used lurasidone, patients in the maintenance phase can switch to lurasidone treatment if they meet the indications for drug change .

Some practical advice from experts:< /h1>

①Patient education should be done well before medication, so that patients have anticipatory preparations for adverse reactions;

②Low dose starting At the beginning, slow down the titration speed, gradually increase the dose after the patient tolerates it, and reduce the dose appropriately if necessary;

Drowsiness, dizziness caused by drugs, etc. It mostly occurs before and after the peak concentration of the drug is reached, such as during 2-3 hours after taking the drug. By taking lurasidone with dinner or before going to bed (the intake of calories exceeds 350 kcal when taking it), reduces the influence of drowsiness and dizziness on patients, and to a certain extent Improve sleep of patients;

nausea caused by drugs occurs in the early stage of medication, generally no special treatment is needed,Most patients can tolerate it after two or three days of taking the medicine, and they can also choose to take it with food or before going to bed to relieve it.

In general, lurasidone significant curative effect on psychotic symptoms, emotional symptoms, and cognitive symptoms of patients, and less impact on metabolic indicators and prolactin, with good safety and Tolerance. In addition, lurasidone is convenient as it only needs to be taken once a night.

This is Director Liu, you can talk to me if you have any questions.