Schizophrenia - lurasidone
According to the WHO, as much as 10% of the global population suffers from schizophrenia. The chronic condition often leads to a breakdown in mental processes and a loss of contact with reality.
According to the WHO, as much as 10% of the global population suffers from schizophrenia. The chronic condition often leads to a breakdown in mental processes and a loss of contact with reality.
Patients suffer from positive symptoms, including auditory hallucinations, delusions, bizarre thoughts and irrational fears, and negative ones, including social withdrawal, lack of motivation and energy, and apathy.
Treatment was historically with antipsychotics such as haloperidol or chlorpromazine, but side-effects are common with these drugs. More recent atypical antipsychotics have fewer side-effects, but a third of schizophrenics continue to suffer severe symptoms, despite drug treatment. The negative symptoms are particularly difficult to treat.
Newer drugs tend to be dual dopamine D2 and 5-HT2A antagonists, which have varying effects on the two receptors; another that is under development is Dainippon Sumitomo's lurasidone. It has a different binding profile from existing atypical antipsychotics, and appears to improve the negative symptoms as well as the positive ones.
Its safety and tolerability were investigated in a trial in 180 patients with schizophrenia experiencing an acute exacerbation. Subjects were given the drug or placebo for up to six weeks.1 Nausea was more common in the lurasidone group, but this was mild to moderate. Discontinuation was more common in the treated group at 6.7% than the placebo group at 1.1%, but no clear pattern of side-effects leading to discontinuation was determined. It did not have significant effects on lipid levels, glucose regulation or weight gain.
In a multicentre, randomised double blind Phase II trial, 180 patients were given 80mg of the drug or placebo a day.2 At the 80mg dose, a significant improvement on both the positive and negative syndrome scale and the clinical global impression severity score was seen compared with placebo. In a second trial in 132 patients, doses of 40 and 120mg once a day proved better than placebo at improving the brief psychiatric rating scale after 42 days.3 The drug was safe and well tolerated. Phase III studies are under way.