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Review
. 2025 Feb;14(1):85-98.
doi: 10.1007/s40120-024-00700-y. Epub 2025 Jan 6.

Efficacy of Lurasidone in First-Episode Psychosis: Patient Phenotypes, Dosage, and Recommendations from an Expert Panel

Miquel Bernardo  1 , Marina Díaz Marsá  2 , Ana González-Pinto  3 , Manuel Martín Carrasco  4 , Víctor Pérez Sola  5 , Pilar Alejandra Sáiz  6 , Eduard Vieta  7 , Marta Torrens  5 , Celso Arango  8 , Benedicto Crespo-Facorro  9
Affiliations
Review

Efficacy of Lurasidone in First-Episode Psychosis: Patient Phenotypes, Dosage, and Recommendations from an Expert Panel

Miquel Bernardo et al. Neurol Ther. 2025 Feb.

Abstract

Introduction: For patients with psychosis, early, intensive therapeutic intervention is thought to improve long-term outcomes. Furthermore, patients with a first-episode psychosis (FEP) who experience a good early response to antipsychotic medication show a clinical and functional benefit over the longer term if they continue low-dose antipsychotic treatment. Lurasidone is an atypical antipsychotic agent which is approved in Europe for the treatment of schizophrenia in adults and adolescents (13-17 years). The efficacy and tolerability of lurasidone have been demonstrated in both antipsychotic-naïve and previously treated patients.

Areas covered: This paper provides a review and commentary regarding the use of lurasidone in patients with FEP. Case studies based on the authors' clinical experiences with lurasidone in real-world practice are provided.

Expert opinion: In our experience, lurasidone has shown efficacy in FEP in different patient profiles, including those with psychoses associated with substance use disorders. Lurasidone provides clinically relevant benefits, especially in patients with affective symptomatology, and has a good tolerability profile.

Keywords: Antipsychotic; First-episode psychosis; Lurasidone; Schizophrenia; Tolerability; Treatment.

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Conflict of interest statement

Declarations. Conflict of Interest: Miquel Bernardo has received grants and/or served as a consultant, advisor or speaker for AB-Biotics, Abartis Pharma, Adamed, Angelini Pharma, Casen Recordati, Esteve, Janssen-Cilag, Menarini, Rovi and Takeda. Marina Díaz Marsá has received grants and/or served as a consultant, advisor or speaker for Alter, Angelini, Idorsia, Janssen-Cilag, Lundbeck, Novartis, Otsuka, Rovi, Takeda, the Ministry of Science (Carlos III Institute), the Basque Government, and the European Framework Program of Research. Ana González-Pinto has received grants and/or served as a consultant, advisor or speaker for Janssen-Cilag, Lundbeck, Otsuka, Alter, Angelini, Novartis, Rovi, Takeda, Servier, the Spanish Ministry of Science and Innovation (CIBERSAM), the Ministry of Science (Carlos III Institute), the Basque Government, and the European Framework Program of Research. Manuel Martín Carrasco has received grants and served as a consultant, advisor or CME speaker for Angelini, Esteve, Idorsia, Janssen-Cilag, Lundbeck, Novartis, Pfizer, Rovi, the Ministry of Science (Carlos III Institute), and the Navarra Government. Víctor Pérez Sola has received grants and/or served as a consultant, advisor or speaker for AB-Biotics, AstraZeneca, Bristol-Myers-Squibb, Johnson & Johnson, Lundbeck, Medtronic, Otsuka, and Servier. Pilar Alejandra Sáiz has received grants and/or served as a consultant, advisor or speaker for Adamed, Alter Medica, Angelini Pharma, CIBERSAM, Ethypharm Digital Therapy, European Commission, Government of the Principality of Asturias, Instituto de Salud Carlos III, Johnson & Johnson, Lundbeck, Otsuka, Pfizer, Plan Nacional Sobre Drogas and Servier. Eduard Vieta has received grants and/or served as a consultant, advisor or speaker for AB-Biotics, AbbVie, Adamed, Angelini Pharma, Biogen, Beckley-Psytech, Biohaven, Boehringer-Ingelheim, Celon Pharma, Compass, Dainippon Sumitomo Pharma, Ethypharm, Ferrer, Gedeon Richter, GH Research, GlaxoSmithKline, HMNC, Idorsia, Johnson & Johnson, Lundbeck, Luye Pharma, Medincell, Merck, Neuraxpharm, Newron, Novartis, Orion Corporation, Organon, Otsuka, Roche, Rovi, Sage, Sanofi-Aventis, Sunovion, Takeda, Teva, and Viatris. Marta Torrens has received grants and/or served as a consultant, advisor or speaker for Adamet, Angelini Pharma, Camurus, Lundbeck, Otzuka, and Servier. Celso Arango has received grants and/or served as a consultant, advisor or speaker for Acadia, Ambrosetti S.p.A, Angelini, Bristol-Myers Squibb, Comunidad de Madrid, Fundación Alicia Koplowitz, Fundación Familia Alonso, Fundación Mutua Madrileña, Instituto de Salud Carlos III, Janssen-Cilag, Lundbeck, Ministerio Educación, Otsuka, Rovi, Stanley Foundation, Sunovion, Teva, and Takeda. Benedicto Crespo-Facorro has received grants and/or served as a consultant, advisor or speaker for Angelini, Johnson & Johnson, Lundbeck, Otsuka, and Rovi. Ethical Approval: This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors.

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