Case Series Reports on Lurasidone-Associated Mania

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To the Editors
The morbidity and mortality for bipolar depression are well established, and current available treatments are often limited by adverse effects.1 Lurasidone, marketed in the United States as Latuda by Sunovion Pharmaceuticals, is an atypical antipsychotic approved by the US Food and Drug Administration for schizophrenia and the depressive phase of bipolar disorder.1,2 Lurasidone has several benefits over existing treatment for bipolar depression, including reduced corrected QT interval (QTc) on electrocardiogram prolongation, lower risk of metabolic dysfunction, and sedation.2 Lurasidone remains a practical option in patients with comorbidities that may limit use of other antipsychotics.
Although indicated for the treatment of bipolar depression, understanding of lurasidone's effects on other phases of bipolar disorder, including euthymia and mania, remains limited. Although considered rare, treatment-emergent mania has been documented with the use of atypical antipsychotics.3 The goals of this case series are to highlight clinical instances in which lurasidone has been associated with induction of mania and to propose possible mechanisms as to why this occurs. In our university inpatient and outpatient psychiatric service, there were 10 identified cases that were associated with lurasidone and mania. Five cases were chosen for their clarity of diagnosis and clinical course for discussion.
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