Lurasidone is a new atypical antipsychotic that is effective for short- and long-term treatment of patients with schizophrenia. It joins ziprasidone and aripiprazole as ‘metabolically friendly’ treatments but, unlike ziprasidone, has a low risk of causing QT prolongation. Possible side effects include akathisia and parkinsonism.
Schizophrenia and related psychotic disorders share the common aetiology of brain dopamine dysregulation. Midbrain dopamine overactivity is hypothesised to cause delusions, hallucinations and formal thought disorder. All antipsychotics block dopamine D2 receptors to some extent and remain the cornerstone of treatment for patients with psychoses. The new generation or atypical antipsychotics distinguish between the D2 receptors thought to be responsible for psychosis and those responsible for movement, resulting in a low risk of extrapyramidal side effects such as parkinsonism. However, these drugs can cause other problems, most particularly weight gain and metabolic syndrome.1
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