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Also, Switch to Latuda (Lurasidone)?

Posted by LouisianaSportsman on October 18, 2013, at 14:07:42

In reply to Is this a normal way for a PDOC to address ADHD?, posted by LouisianaSportsman on October 16, 2013, at 20:51:19

The Abilify (aripiprazole) makes me gain weight. One reason, I believe, she prescribed me the Adderall and bupropion was to help counter this weight gain. We were going to try Topamax as an adjunct mood stabilizer for its weight-loss properties as well. I love Abilify, it is the most effective medicine I have ever taken, but I can't deal with the weight gain; I've made many lifestyle changes, but they can't seem to conquer the metabolic effects of aripiprazole.

I've read that lurasidone has the lowest weight-gain of the atypical antipsychotics (AAPs). From Wikipedia:

"low propensity for QTc interval changes, weight and lipid-related adverse effects ... was found to produce the second least (after haloperidol) weight gain, the least QT interval prolongation, the fourth most extrapyramidal side effects and the sixth least sedation (after aripiprazole)."

I've never gotten EP or sedation symptoms from Abilify so I'm hoping Latuda is no different. The weight loss thing sounds crucial.

We chose aripiprazole because it still allows for some endogenous dopamine due to its partial agonism which I also hoped theoretically would mean that it'd allow ADHD stimulants to work better than with other AAPs. How well does Latuda work with stimulants? I've read case reports which suggest they will be attenuated similarly to Abilify but still exert therapeutic value.

Also, according to Wikipedia:

"Lurasidone may be useful for treating the cognitive and memory deficits seen in schizophrenia ... and was found to be superior in doing this to all of the other antipsychotics examined ... Lurasidone has activity at several serotonin receptors that are involved in learning and memory, and unlike most other antipsychotics, lacks any anticholinergic effects (which are known to impair cognitive processes and memory). These properties may underlie its improved effectiveness in treating these symptoms relative to older agents."

I definitely need pro-cognitive effects since I suffer from ADHD. It also has FDA approval for bipolar I depression and I suffer from a form of bipolar depression myself.

Lurasidone even shares aripiprazole's partial agonism at 5-HT1A which is good. It seems similar in every way except that it causes less weight gain. I don't see any reason to not try it instead?


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poster:LouisianaSportsman thread:1052412
URL: http://www.dr-bob.org/babble/20130930/msgs/1052482.html