Schizophrenia

Antipsychotic May Help Treat Agitation Linked With Schizophrenia

The atypical antipsychotic lurasidone may be useful in reducing agitation in patients with an acute exacerbation of schizophrenia, a post-hoc analysis of 5 studies has found.

The findings were published in the July-August issue of General Hospital Psychiatry.

Researchers analyzed data from 6-week, randomized, double-blind, placebo-controlled studies of 40 mg/day to 160 mg/day of oral lurasidone. They assessed agitation with the Positive and Negative Syndrome Scale–Excited Component (PANSS-EC) score, using a mixed model for repeated measurement analysis.

Overall, they found, lurasidone was associated with “early and sustained” reduction in mild to moderate levels of agitation in acutely ill patients with schizophrenia. But results varied based on the level of agitation at baseline.

In 773 patients who had higher levels of agitation at baseline, defined as a PANSS-EC score of 14 or greater, lurasidone was associated with significantly greater improvement, versus placebo, at Day 3/4, Day 7, and through the endpoint. In 754 patients with lower agitation at baseline (a PANSS-EC score of less than 14), score change was significantly greater for lurasidone compared with placebo at Day 7 through the endpoint.

In addition, “higher doses of lurasidone were notably more effective than lower doses in patients with more severe agitation at study baseline,” wrote Michael H. Allen, MD, of the Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, and colleagues.

The most common side effects were akathisia, somnolence, and insomnia. Patients with agitation so severe it required emergency intervention were not included in the trials used in the analysis.

—Terri Airov

Reference

Allen MH, Citrome L, Pikalov A, Hsu J, Loebel A. Efficacy of lurasidone in the treatment of agitation: a post hoc analysis of five short-term studies in acutely ill patients with schizophrenia. General Hospital Psychiatry. 2017;47:75-82.