San Luigi Gonzaga Hospital, University of Turin, 10043 Orbassano, Italy.
Department of Neurosciences, Imaging and Clinical Sciences, Università Degli Studi G. D'Annunzio Chieti-Pescara, 66100 Chieti, Italy.
Int J Environ Res Public Health. 2022 Nov 30;19(23):16057. doi: 10.3390/ijerph192316057.
Lurasidone is an atypical antipsychotic approved for the acute and maintenance treatment of schizophrenia. Recently, lurasidone was also extended FDA approval for adults with major depressive episodes associated with bipolar I disorder (bipolar depression), as either a monotherapy or as adjunctive therapy with lithium or valproate. The use of low doses of atypical antipsychotics is an essential component of early intervention in psychosis, but little has yet been studied on first episode cannabis-induced psychosis. For its particular performance and tolerability, lurasidone is becoming an important option for the treatment of first-episode psychosis in youth. Case presentation four patients experiencing first cannabis-induced psychotic episode were treated with lurasidone. In all patients, there was an improvement in the clinical picture of psychosis. The recovery was positive, not only with the remission of positive and negative symptoms, but also regarding disruptive behaviour, with the return of functioning. All the patients were treated with lurasidone, with a target dose of 74-128 mg/day. No significant side effects were reported.
There are non-controlled studies for the use of lurasidone in first episode psychosis cannabis induced. These findings suggest that lurasidone is an atypical antipsychotic beneficial in this clinical picture. Treatment with medium-high doses of lurasidone could be effective and tolerable in this phase of the disorder. Randomized control trials with longer follow-up are recommended to confirm these positive results.
鲁拉西酮是一种新型抗精神分裂症药物，已被批准用于治疗精神分裂症的急性期和维持期。最近，鲁拉西酮也获得了美国食品药品监督管理局（FDA）的批准，可用于治疗伴有双相 I 型障碍（双相情感障碍）的成人重性抑郁发作，无论是单药治疗还是与锂或丙戊酸盐联合治疗。在精神病的早期干预中，使用低剂量的非典型抗精神病药物是一个重要的组成部分，但对于首次发作的大麻引起的精神病，研究还很少。由于其特殊的疗效和耐受性，鲁拉西酮正在成为治疗青少年首发精神病的重要选择。
四名经历首次大麻引起的精神病发作的患者接受了鲁拉西酮治疗。在所有患者中，精神病的临床症状均有所改善。康复情况良好，不仅阳性和阴性症状得到缓解，而且行为障碍也得到改善，功能恢复正常。所有患者均接受鲁拉西酮治疗，目标剂量为 74-128mg/天。未报告明显的副作用。
对于大麻诱导的首发精神病，有非对照研究使用鲁拉西酮。这些发现表明，鲁拉西酮是一种对这种临床情况有益的非典型抗精神病药物。在疾病的这个阶段，使用中高剂量的鲁拉西酮可能是有效且可耐受的。建议进行随机对照试验，进行更长时间的随访，以证实这些积极的结果。
