Discontinuation Rate of Lurasidone and Quetiapine Extended Release in Bipolar Depression

Abstract

Introduction Lurasidone (LUR) was compared with quetiapine extended release (QUE-ER) regarding 1-year discontinuation in patients with bipolar depression (n=317).

Methods This is a retrospective cohort study.

Results Although the time to all-cause discontinuation was estimated using the Kaplan–Meier survival curve with log-rank tests to compare treatment groups, no difference was found (p=0.317). The Cox proportional hazard model revealed that only the presence of adverse events (AEs) is associated with increased treatment discontinuation (p<0.0001). The most common AEs were akathisia for LUR (17.7%) and somnolence for QUE-ER (34.7%). In other Cox models divided by LUR or QUE-ER, the presence of akathisia or somnolence was associated with increased LUR (p=0.0205) or QUE-ER (p<0.0001) discontinuation, respectively.

Discussion The acceptability of both antipsychotics to bipolar depression in clinical practice may be similar. However, specific AEs for each antipsychotic (LUR: akathisia and QUE-ER: somnolence) were associated with high treatment discontinuation.

Keywords

lurasidone - quetiapine extended release - bipolar depression

Publikationsverlauf

Eingereicht: 06. März 2024
Eingereicht: 11. April 2024

Angenommen: 13. Mai 2024

Artikel online veröffentlicht:
19. Juni 2024

• References

• 1 Nierenberg AA, Agustini B, Kohler-Forsberg O. et al. Diagnosis and treatment of bipolar disorder: A Review. JAMA 2023; 330: 1370-1380
• 2 Kishi T, Ikuta T, Matsuda Y. et al. Mood stabilizers and/or antipsychotics for bipolar disorder in the maintenance phase: A systematic review and network meta-analysis of randomized controlled trials. Mol Psychiatry 2021; 26: 4146-4157
• 3 Kishi T, Sakuma K, Okuya M. et al. Effects of a conventional mood stabilizer alone or in combination with second-generation antipsychotics on recurrence rate and discontinuation rate in bipolar I disorder in the maintenance phase: A systematic review and meta-analysis of randomized, placebo-controlled trials. Bipolar Disord 2021; 23: 789-800
• 4 Lieberman JA, Stroup TS, McEvoy JP. et al. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 2005; 353: 1209-1223
• 5 Kishi T, Ikuta T, Matsuda Y. et al. Pharmacological treatment for bipolar mania: A systematic review and network meta-analysis of double-blind randomized controlled trials. Mol Psychiatry 2022; 27: 1136-1144
• 6 Yildiz A, Siafis S, Mavridis D. et al. Comparative efficacy and tolerability of pharmacological interventions for acute bipolar depression in adults: A systematic review and network meta-analysis. Lancet Psychiatry 2023; 10: 693-705
• 7 APA. Diagnostic and statistical manual of mental disorders, 5th ed. American Psychiatric Association; Arlington: 2013
• 8 Zhang Z. Variable selection with stepwise and best subset approaches. Ann Transl Med 2016; 4: 136
• 9 Wu H, Siafis S, Wang D. et al. Antipsychotic-induced akathisia in adults with acute schizophrenia: A systematic review and dose-response meta-analysis. Eur Neuropsychopharmacol 2023; 72: 40-49
• 10 Li Q, Wang J, Wang ZL. et al. The impacts of CYP3A4 genetic polymorphism and drug interactions on the metabolism of lurasidone. Biomed Pharmacother 2023; 168: 115833
• 11 Lin SK. Racial/ethnic differences in the pharmacokinetics of antipsychotics: focusing on East Asians. J Pers Med 2022; 12
• 12 Kato T, Ishigooka J, Miyajima M. et al. Double-blind, placebo-controlled study of lurasidone monotherapy for the treatment of bipolar I depression. Psychiatry Clin Neurosci 2020; 74: 635-644
• 13 Murasaki M, Koyama T, Kanba S. et al. Multi-center, randomized, double-blind, placebo-controlled study of quetiapine extended-release formulation in Japanese patients with bipolar depression. Psychopharmacology (Berl) 2018; 235: 2859-2869