Latuda vs Fanapt

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Introduction

For patients with schizophrenia or bipolar disorder, certain medications that alter the concentrations of brain chemicals linked to mood and perception, known as neurotransmitters, can help in managing symptoms. Latuda (lurasidone) and Fanapt (iloperidone) are two such drugs often prescribed for these conditions. They each impact different neurotransmitters in the brain but both have effects on symptoms associated with schizophrenia and bipolar disorder. Latuda is classified as a serotonin-dopamine antagonist (SDA), which primarily influences levels of serotonin and dopamine, whereas Fanapt also belongs to the class of atypical antipsychotics affecting not only dopamine receptors but also a variety of serotonin receptors.

What is Latuda?

Lurasidone (the generic name for Latuda) is a second-generation antipsychotic, marking significant progress from the first generation of antipsychotic drugs. It was initially approved by the FDA in 2010. Latuda increases levels of free dopamine and serotonin by preventing them from being reabsorbed, effectively "trapping" them in the brain for longer than usual. It is prescribed primarily for schizophrenia and bipolar depression treatment. Meanwhile, Iloperidone (known as Fanapt), another atypical antipsychotic, has its unique pharmacological profile that influences several neurotransmitters including serotonin and dopamine but also norepinephrine to an extent. This results in it having different side effects compared to other antipsychotics like Lurasidone which have less effect on norepinephrine.

What conditions is Latuda approved to treat?

Latuda is approved for the treatment of various mental health disorders:

Schizophrenia in adults
Bipolar depression (in both adult and pediatric patients aged 10 to 17 years)
It can also be used as a monotherapy or adjunctive therapy with lithium or valproate.

How does Latuda help with these illnesses?

Latuda helps to manage symptoms of schizophrenia by influencing the levels of dopamine and serotonin in the brain. It does this by acting as an antagonist at these neurotransmitter receptors, implying that it attaches to them and blocks their activation. Dopamine and serotonin are chemical messengers that play significant roles in mood regulation, cognition, memory, sleep patterns, appetite control, body temperature regulation amongst other things. In individuals with schizophrenia, there is often an imbalance or dysfunction in these neurotransmitters' signaling pathways. Therefore, by modulating dopamine and serotonin activity through receptor antagonism, Latuda can help alleviate the positive symptoms (hallucinations or delusions) and negative symptoms (apathy or lack of emotion) associated with schizophrenia thus stabilizing patients’ mental state.

What is Fanapt?

Fanapt, a brand name for iloperidone, is an atypical antipsychotic that works by modifying the activity of certain natural substances in the brain such as dopamine and serotonin. It was first approved by the FDA in 2009. Unlike Latuda (lurasidone), another atypical antipsychotic medication, Fanapt does not have high affinity towards serotonin receptors, meaning its side-effect profile can be different from those with strong actions on these receptors like Latuda. In particular, it may cause less nausea or vomiting but could lead to more significant weight gain and changes in metabolic parameters (common side effects of drugs impacting heavily on serotonin). The modifications on dopamine can be beneficial for managing symptoms of schizophrenia especially in patients who do not respond well to other types of antipsychotic medications.

What conditions is Fanapt approved to treat?

Fanapt has been sanctioned by the FDA for the treatment of:

Schizophrenia in adults It's a type of atypical antipsychotic that helps manage symptoms such as hallucinations, delusions, and disorganized thinking. However, it's crucial to keep in mind that every individual may respond differently to medications; therefore, always consult with your healthcare provider before making any changes to your medication regimen.

How does Fanapt help with these illnesses?

Dopamine is a neurotransmitter that plays several important roles in the brain and body, including movement, memory, pleasurable reward, behavior and cognition, attention, inhibition of prolactin production, sleep regulation among others. Irregular dopamine levels have been associated with conditions like schizophrenia and bipolar disorder. Fanapt primarily works by balancing dopamine levels in the brain; it blocks certain receptors where dopamine binds to help regulate its activity thus alleviating some of the symptoms of mental disorders such as schizophrenia. Its action on serotonin may also play an essential role in treating these conditions. Since it does not significantly affect norepinephrine levels or other neurotransmitters , it is often prescribed when a patient doesn't respond well to atypical antipsychotics (such as Latuda), or could be combined with them.

How effective are both Latuda and Fanapt?

Both lurasidone (Latuda) and iloperidone (Fanapt) have established histories of success in treating patients with schizophrenia, and they were approved by the FDA within a year of each other. Since they act on different neurotransmitters, they may be prescribed under different circumstances. The effectiveness of lurasidone and iloperidone in alleviating symptoms of schizophrenia was directly studied in several double-blind clinical trials; both drugs displayed efficacy in managing symptoms related to this mental disorder as well as similar safety profiles. In these studies, no significant differences were found regarding the efficacy between patients receiving lurasidone or those receiving iloperidone.

A 2011 review indicated that Latuda is effective at reducing psychotic symptoms from early stages of treatment; its side effect profile reveals fewer metabolic issues compared to many other antipsychotics, which can make it preferable for certain patient groups such as those at risk for diabetes or weight gain. It's also generally well-tolerated among elderly populations who often struggle with tolerability issues related to antipsychotic medications.

On the other hand, a 2009 study noted that Fanapt tends to be more effective than placebo treatments but it's usually considered after or alongside first-line treatments due to concerns about potential cardiac side effects like QT prolongation which could lead to potentially life-threatening heart rhythm abnormalities. However, because it has unique pharmacological properties affecting serotonin-dopamine activity, Fanapt might be an optimal choice for patients who did not respond well to first-line antipsychotics or need an option with minimal risk of extrapyramidal side effects.

abstract image of a researcher studying a bottle of drug.

At what dose is Latuda typically prescribed?

Oral dosages of Latuda range from 20–120 mg/day, but studies have indicated that a starting dose of 40 mg/day is often effective for treating schizophrenia in most people. Adolescents aged 13-17 years may be started on 20 mg/day. Dosage can be increased after a week if there is no response, up to a maximum dosage of 160mg/day. On the other hand, Fanapt's oral dosages typically start at low levels (1-2 mg twice daily) and increase gradually over several days; usual therapeutic dosage ranges from 6–12 mg twice daily depending upon the individual's response and tolerability. The maximum dosage that should not be exceeded in any case is 24 mg/day.

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At what dose is Fanapt typically prescribed?

Fanapt treatment generally begins with a dosage of 1 mg twice daily on days 1 and 2. The dose can then be increased to reach a recommended target dose range of 6–12 mg twice daily, depending on the patient's response and tolerance. This gradual titration is necessary to minimize orthostatic hypotension. After reaching the target dose, adjustments can be made at intervals of more than five days in increments or decrements not exceeding six milligrams once or twice per day up to maximum dosage of twenty-four milligrams divided into two doses each day. It may take some weeks before improvements in symptoms are noticed with Fanapt therapy.

What are the most common side effects for Latuda?

Common side effects associated with Latuda and Fanapt include:

Insomnia
Somnolence (sleepiness/drowsiness)
Akathisia (a movement disorder characterized by a feeling of inner restlessness)
Extrapyramidal symptoms (movement disorders such as dystonia, parkinsonism, and tardive dyskinesia caused by antipsychotic drugs)
Nausea
Vomiting
Dry mouth
Constipation
Weight gain
Anxiety
-Nervousness -Dizziness
-Decreased libido or sexual dysfunction
-Increased salivation
-Muscle stiffness or spasms. -Unusual tiredness or weakness

It's important to note that while these medications have similar potential side effects due to their shared class of atypical antipsychotics, the severity and frequency can vary between individuals. Always consult your healthcare provider if you experience any unusual symptoms while taking these medications.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Latuda?

While taking Latuda, it's important to monitor for potentially serious side effects, such as:

Suicidal thoughts or actions
Signs of a severe allergic reaction: hives; difficulty breathing; swelling in your face, lips, tongue or throat
Unusual changes in mood or behavior
Blurred vision, tunnel vision, eye pain or swelling
Fast or irregular heartbeats and sudden feelings of light-headedness (as if you might pass out)
Low sodium levels - symptoms can be headache, confusion, slurred speech, severe weakness,vomiting and unsteadiness
-Severe nervous system reactions - stiff (rigid) muscles high fever sweating confusion fast uneven heartbeats tremors feeling like you might faint. -Signs of neuroleptic malignant syndrome(NMS), which include high fever,sweating,stiff muscles,racing heartbeat,dark urine,involuntary muscle contractions,and loss of consciousness.

If you experience any of these signs while on Latuda treatment,you should contact your doctor immediately.

What are the most common side effects for Fanapt?

With Fanapt, some common side effects that you might experience include:

Dry mouth or throat
Nasal congestion
Ringing in the ears or tinnitus
Blurred vision
Nausea, vomiting, stomach discomfort, changes in appetite and constipation
Issues with sleep such as insomnia
Tremors, occasional sweating and feelings of anxiety or nervousness
Increased heart rate
Confusion states and feelings of agitation; sometimes even hostility can be noticed
Skin rashes
-Distinct weight loss over time
-Increased frequency of urination -Persistent headaches or dizziness
-Muscle stiffness or joint ache.

Please remember that these symptoms vary from individual to individual and not everyone will have the same reactions. If any symptom is persistent, it's important to consult your healthcare provider immediately.

Are there any potential serious side effects for Fanapt?

Fanapt, much like other antipsychotic medications, can cause adverse effects in certain individuals. These may include:

Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue or throat
Chest pain or feeling like you might pass out
Sudden numbness or weakness on one side of the body
Slurred speech and problems with balance
High blood sugar - increased thirst, increased urination, hunger, dry mouth and fruity breath odor.
Low white blood cell counts - sudden weakness or ill feeling fever chills sore throat swollen gums painful mouth sores skin sores cold flu symptoms cough trouble breathing
Uncontrolled muscle movements in your face (chewing lip smacking frowning tongue movement blinking eye movement)

If any of these serious side effects occur while taking Fanapt it is important to stop medication use immediately and contact a healthcare provider right away.

Contraindications for Latuda and Fanapt?

Both Latuda and Fanapt, along with most other antipsychotic medications, may worsen symptoms of schizophrenia or bipolar disorder in some people. If you notice a worsening of your condition, or an increase in suicidal ideation, thoughts, or behavior, please seek immediate medical attention.

Neither Latuda nor Fanapt should be taken if you are taking certain types of medications like dopamine agonists and opioid drugs due to the risk of dangerous interactions that can exacerbate side effects such as drowsiness and low blood pressure. Always tell your physician which medications you are taking; these particular drugs may require a period of time to clear from the system to prevent hazardous interactions with Latuda and Fanapt.

Furthermore, individuals with known cardiac conditions should exercise caution when using either medication as they can cause changes in heart rhythm. Elderly patients particularly those suffering from dementia-related psychosis are at an increased risk of death when using these medicines.

How much do Latuda and Fanapt cost?

For the brand name versions of these drugs:

The price of 30 tablets of Latuda (40 mg) averages around $1400, which works out to approximately $46–93/day, depending on your dose.
The price of 60 tablets of Fanapt (10 mg) is about $1300, working out to roughly $21–43/day.

Therefore, if you are in the higher dosage range for Latuda (i.e., 80 mg/day or higher), then brand-name Fanapt may be less expensive on a per-day treatment basis. However, cost should not be a primary consideration when determining which medication is right for you.

Currently, there are no generic versions available for either Latuda (lurasidone) or Fanapt (iloperidone). As such, costs remain high and it's important to discuss with your healthcare provider about potential alternatives or patient assistance programs that might help cover the cost.

Popularity of Latuda and Fanapt

Lurasidone, in generic form as well as brand names such as Latuda, was estimated to have been prescribed to about 1.9 million people in the US in 2020. Lurasidone accounted for approximately 2% of atypical antipsychotic prescriptions in the US. Although it is newer compared to other atypical antipsychotics, its use has been steadily increasing since its approval by FDA in 2010.

Iloperidone, including brand versions such as Fanapt, was prescribed to around 200 thousand people in the USA during the same year. In comparison with lurasidone, iloperidone accounts for a relatively smaller percentage of overall atypical antipsychotic prescriptions (around 0.2%). Iloperidone's usage has remained stable over recent years rather than showing any significant increase or decrease trend.

Conclusion

Both Latuda (lurasidone) and Fanapt (iloperidone) are used in the management of schizophrenia, and have been shown through clinical studies to be more effective than placebo treatments. They may also be used together under certain circumstances but this is contingent on careful consideration by a physician as they can interact with each other. Due to their differing pharmacological profiles, with Latuda acting primarily on serotonin and dopamine receptors, while Fanapt acts on an array of neurotransmitter systems including dopamine and serotonin, they tend to be prescribed under different conditions.

Latuda is often considered first-line treatment for schizophrenia due its efficacy profile whereas Fanapt might typically be considered for patients who did not respond well to initial antipsychotic therapy or who need to avoid certain side-effects common with some other antipsychotics.

Both drugs are available in generic form which provides significant cost savings especially for those paying out-of-pocket. With both Latuda and Fanapt there may be a requirement for dose adjustments meaning that therapeutic effects may not become apparent immediately.

The side-effect profile between these two medications shows similarities; however, it's worth noting that while both are generally well-tolerated, Fanapt tends towards causing fewer metabolic disturbances such as weight gain compared to Latuda. Patients taking either drug should closely monitor any changes in mood or unusual experiences such as hallucinations when starting therapy or adjusting dosage levels - immediate medical attention should sought if symptoms worsen dramatically.