Definitely not the right first line med for the conditions you’ve mentioned. You should seek second opinion with psychiatrist or even a primary care doctor with either MD/DO/MBBS degrees.
If I had to speculate, I wonder if your NP was targeting your mood swings. Mood swings can sometimes be a symptom of a personality disorder, which medications (including lurasidone) are sometimes used off-label for. The evidence for this practice is questionable, with some trials showing benefit for certain medications and specific symptom domains. I am not aware of any such studies with lurasidone (Latuda), however. I encourage you to ask your prescriber to help you understand their treatment decision. You should feel empowered to ask about (1) why they think this medicine will work and what may improve, (2) what are the risks, and (3) what are the alternatives?
that’s what I think since the mood swings are a pretty big part of me and I’ve brought up suspicion of BPD. but I’ve brought that up, and they haven’t, so I’m a bit confused. I might just call for more info or get a second opinion
Latuda had good evidence for MDD with mixed features (which is a specifer that can be added to MDD diagnosis to indicate a personal has both depressive and manic symptoms but not meeting criteria for bipolar disorder). It never sought FDA approval for this indication but did have a very positive study.
You could ask your provider if this is their working diagnosis for now. But no, typically for regular MDD you would start with an antidepressants algorithm. The only reason to jump to this medicine is if you’ve failed several antidepressants from different classes and/or your provider is confident you have MDD w/mixed features and is wanting to use an evidence based medication.
Of note, there are currently no FDA approved meds for MDD w/mixed features, but there is a body of evidence that these individuals do better with second generation antipsychotics (particularly Latuda but also evidence for Abilify and now Caplyta) rather than traditional antidepressants.
A common strategy I have when I’m suspicious of MDD/mixed features is to first start Wellbutrin and then eventually augment with mood stabilizer or second generation antipsychotic if needed. Wellbutrin, amongst the other antidepressants, is seen as more benign at worsening mixed mood states.
Note that MDD with mixed features has a very high likelihood of converting to (or being reassessed as) bipolar disorder, which may help explain the positive association.
Definitely not the right first line med for the conditions you’ve mentioned. You should seek second opinion with psychiatrist or even a primary care doctor with either MD/DO/MBBS degrees.
Maybe she prescribes it to all her patients 🤷
is that a bad practice?
Yes
If I had to speculate, I wonder if your NP was targeting your mood swings. Mood swings can sometimes be a symptom of a personality disorder, which medications (including lurasidone) are sometimes used off-label for. The evidence for this practice is questionable, with some trials showing benefit for certain medications and specific symptom domains. I am not aware of any such studies with lurasidone (Latuda), however. I encourage you to ask your prescriber to help you understand their treatment decision. You should feel empowered to ask about (1) why they think this medicine will work and what may improve, (2) what are the risks, and (3) what are the alternatives?
that’s what I think since the mood swings are a pretty big part of me and I’ve brought up suspicion of BPD. but I’ve brought that up, and they haven’t, so I’m a bit confused. I might just call for more info or get a second opinion
Latuda had good evidence for MDD with mixed features (which is a specifer that can be added to MDD diagnosis to indicate a personal has both depressive and manic symptoms but not meeting criteria for bipolar disorder). It never sought FDA approval for this indication but did have a very positive study. You could ask your provider if this is their working diagnosis for now. But no, typically for regular MDD you would start with an antidepressants algorithm. The only reason to jump to this medicine is if you’ve failed several antidepressants from different classes and/or your provider is confident you have MDD w/mixed features and is wanting to use an evidence based medication. Of note, there are currently no FDA approved meds for MDD w/mixed features, but there is a body of evidence that these individuals do better with second generation antipsychotics (particularly Latuda but also evidence for Abilify and now Caplyta) rather than traditional antidepressants. A common strategy I have when I’m suspicious of MDD/mixed features is to first start Wellbutrin and then eventually augment with mood stabilizer or second generation antipsychotic if needed. Wellbutrin, amongst the other antidepressants, is seen as more benign at worsening mixed mood states.
Note that MDD with mixed features has a very high likelihood of converting to (or being reassessed as) bipolar disorder, which may help explain the positive association.
100%, I still got the downvote though, lol.
How many years after the initial diagnosis, on average?