Antipsychotics are psychiatric drugs that are available on prescription, and are licensed to treat the following mental health problems:
- severe depression;
- agitation and psychotic experiences in dementia;
- some forms of bipolar disorder;
- problems with balance and nausea;
- schizoaffective disorder;
- persistent hiccups;
- severe anxiety.
Notes – combining antipsychotic medication with support and other therapy can help sufferers to improve quality of life and manage symptoms.
Antipsychotic medications can also help to clear confusion in an individual with acute psychosis within several days, however, they can take up to 6 weeks to reach their full effect.
List of antipsychotics include:
- aripiprazole (Abilify);
- risperidone (Risperdal);
- asenapine (Saphris);
- loxapine (Loxitane);
- olanzapine (Zyprexa);
- thiothixene (Navane);
- cariprazine (Vraylar);
- molindone (Moban);
- clozapine (Clozaril);
- perphenazine (Trilafon);
- quetiapine (Seroquel);
- trifluoperazine (Stelazine);
- mesoridazine (Serentil);
- ziprasidone (Geodon);
- fluphenazine (Prolixin);
- thioridazine (Mellaril);
- haloperidol (Haldol).
Note – there are two main types of antipsychotics: older antipsychotics (which have been used since the 1950s) and atypical antipsychotics (developed in the 1970s onwards). Both types are thought to work equally well.
Here is a comparison between Rexulti and Latuda, two atypical antipsychotic drugs:
Rexulti (brexpiprazole) belongs to the family of drugs known as second-generation psychotics or atypical antipsychotics.
It was first approved by the US FDA to treat schizophrenia in 2015. It is also approved as an adjunctive option for the major depressive disorder.
Latuda (lurasidone) is an atypical antipsychotic that has been approved by the US FDA since 2010 for the treatment of schizophrenia in adults. In 2013, the FDA approved it as a potential treatment for bipolar depression.
It is indicated in adult patients for the treatment of schizophrenia. It does not cure schizophrenia, however, it helps to manage symptoms by affecting the actions of certain neurotransmitters in the brain.
Additionally, it can be given in combination with an antidepressant to treat depression in adults.
Note – it will probably take a few weeks to see changes in your symptoms to decide if this drug is the right medication for you.
It is used to treat adults with schizophrenia. The drug typically starts providing relief within one month. Also, it may be helpful for agitation associated with dementia and major depressive disorder psychosis.
Mechanism of Action
Rexulti works by interfering with communication among the brain’s nerves.
Latuda is thought to work in relation to the brain’s neurotransmitters serotonin and dopamine.
Possible side effects of Rexulti include:
- a light-headed feeling like you might pass out;
- uncontrolled muscle movements in your face;
- feeling restless or being unable to sit still;
- trouble swallowing;
- weight gain;
- intolerance to heat;
- increased sexual urges;
- feelings of warmth;
- swelling or redness in an arm or leg;
- a seizure (convulsions);
- problems with vision or speech;
- increased thirst;
- sudden numbness or weakness;
- fruity breath odor;
- fast or uneven heartbeats;
- dry mouth;
- high fever;
- increased urination;
- very stiff (rigid) muscles;
- trouble breathing;
- skin and mouth sores.
Possible side effects of Latuda include:
- unusual face or body movements;
- increased saliva;
- decreased sexual ability;
- a late or missed menstrual period;
- shortness of breath;
- abnormal heartbeat;
- a shuffling walk;
- severe muscle stiffness;
- sore throat;
- difficulty falling asleep;
- difficulty breathing or swallowing;
- swelling of your lips, eyes, hands, feet, ankles, face, throat, tongue, or lower legs.
For schizophrenia in adults, the initial dose is 1 mg taken once per day. The maximum dosage is 4 mg taken once per day.
For depression, the initial dose is 0.5 mg or 1 mg once per day. The maximum dosage is 3 mg once per day.
For schizophrenia, the initial dosage is 40 mg once a day. The maximum dosage is 160 mg once a day.
For acute treatment of depressive episodes of bipolar disorder, the dosage ranges from 20 to 120 mg.
Warnings & Precautions
Tell your healthcare professional if you have ever had:
- heart attack;
- liver disease;
- a seizure;
- kidney disease;
- low white blood cell (WBC) counts;
- high or low blood pressure;
- high cholesterol or triglycerides.
Before taking this atypical antipsychotic, you should tell your healthcare professional if you have or have ever had:
- low or high blood pressure;
- a stroke;
- high triglycerides;
- a heart attack;
- high cholesterol;
- heart disease;
- low white blood cell count;
- chest pain;
- kidney disease;
- an irregular heartbeat;
- liver disease;
- Alzheimer’s disease;
- Parkinson’s disease;
- breast cancer.
Note – this atypical antipsychotic is not recommended for use in children under 18 years of age.
Rexulti may interact in a negative way with the following medications:
- rifampin (Rifadin);
- clarithromycin (Biaxin);
- carbamazepine (Tegretol);
- lopinavir/ritonavir (Kaletra);
- paroxetine (Paxil);
- saquinavir (Fortovase);
- fluoxetine (Prozac);
- quinidine (a class I antiarrhythmic agent);
- ritonavir (Norvir);
- etanercept (Enbrel);
- indinavir (Crixivan);
- itraconazole (Sporanox);
- ketoconazole (Nizoral);
- fluconazole (Diflucan).
Latuda may interact in a negative way with the following medications:
- Indinavir (Crixivan);
- Ketoconazole (Nizoral);
- Itraconazole (Sporanox);
- Rifampin (Rifadin);
- Nefazodone (Serzone);
- Carbamazepine (Carbatrol);
- Verapamil (Calan);
- Clarithromycin (Biaxin);
- Diltiazem (Cardizem);
- Ritonavir (Norvir);
- Erythromycin (an antibiotic useful for the treatment of bacterial infections);
- Rifabutin (Mycobutin);
- Ipratropium (a medication which opens up the airways in the lungs);
- Pioglitazone (a drug indicated for the treatment of type 2 diabetes);
- Phenytoin (Dilantin);
- Nelfinavir (Viracept).
Avoid alcohol intake while taking these atypical antipsychotics as alcohol may decrease the benefits and increase the adverse effects of the medications.
Is It Safe During Pregnancy or Breastfeeding?
Taking these atypical antipsychotics in the last 3 months of pregnancy may cause feeding problems, breathing problems, or withdrawal symptoms in the developing fetus. Also, it may not be safe to breastfeed while using these atypical antipsychotics.
Bottom Line – Rexulti vs Latuda
Rexulti (brexpiprazole) is a prescription medication which belongs to a family of drugs called atypical antipsychotics. It is used to treat the symptoms of schizophrenia and the major depressive disorder in adults. It has substantial effects on the D2 dopaminergic receptors (a primary target for most antipsychotic agents) and on the serotonergic receptors (5-HT2A and 5-HT1A).
Latuda (lurasidone) is an atypical antipsychotic which was first approved in 2010 for people living with schizophrenia. Furthermore, it is occasionally indicated to treat depressive symptoms in bipolar disorder. The biggest disadvantages of this drug are the potential long-term side effects, that can include tardive hyperglycemia, dyskinesia, and weight gain.
A 2018 study that looked to assess the relative efficacy and metabolic effects of brexpiprazole and lurasidone in the acute treatment of schizophrenia established that both drugs had similar efficacy. However, lurasidone appears to have a better metabolic profile when compared with brexpiprazole. Also, notable benefits for lurasidone on total cholesterol, weight gain, and low-density lipoprotein were observed.
Sources https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4927015/ https://www.hindawi.com/journals/schizort/2013/423205/ https://journals.lww.com/intclinpsychopharm/Fulltext/2016/07000/The_effect_o https://www.otsuka-us.com/media/static/Rexulti-PI.pdf http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Risk-managem