Can Latuda cause mania?

In this article:

• What is mania?
• Why is there confusion over whether Latuda treats or causes mania?
• Does Latuda treat or cause mania?
• Bottom line

In this article

• What is mania?
• Why is there confusion over whether Latuda treats or causes mania?
• Does Latuda treat or cause mania?
• Bottom line

Latuda is a brand-name prescription drug that contains the active ingredient lurasidone. It is a second-generation antipsychotic, also known as an atypical antipsychotic—in the same drug class as medicines like olanzapine, risperidone, and quetiapine. Latuda works by balancing levels of chemical messengers in the central nervous system (CNS) called dopamine and serotonin. It is approved by the Food and Drug Administration (FDA) for the following conditions:

• Schizophrenia in adults and adolescents 13 years and older
• Depressive episodes associated with bipolar I disorder in adults and pediatric patients 10 years and older (when used as the only treatment, also called monotherapy)
• Depressive episodes associated with bipolar I disorder in adults when used in combination with lithium or valproate (also called adjunctive therapy)

The connection between Latuda and mania can be confusing—we’ll talk more about why, and what the connection is. 

What is mania?

Before we talk about mania, let’s take a step back and talk about bipolar disorder. Bipolar disorder is a mental health condition that causes unusual shifts in mood, energy, concentration, and activity. There are four types of bipolar disorder, with two types, bipolar I or II, being the most common. 

People with bipolar I disorder experience manic episodes lasting at least seven days—or manic symptoms that are very severe and require immediate medical care. People with bipolar I disorder also experience depressive episodes, generally lasting at least 14 days.

Manic episodes, or mania, are periods of extremely energized, excited, elated, or even irritable behavior. This does not mean general excitement, as many people experience excitement—rather, mania can involve serious symptoms that sometimes require hospitalization, such as:

• Thinking you are invincible
• Having racing thoughts on many topics at the same time 
• Talking a lot, and very fast
• Having an obsession with an activity
• Fidgeting or pacing
• Displaying impulsive behavior and poor choices such as shopping sprees or unsafe sex

People with bipolar II disorder experience patterns of depressive symptoms and hypomanic episodes—less severe manic episodes. While manic episodes can severely impact school, work, or daily life and may require hospitalization, hypomanic episodes do not tend to disrupt one’s daily life and do not require hospitalization.

Latuda is only FDA approved to treat depression associated with bipolar I disorder—but is not FDA approved to treat manic episodes. It is not approved for use in people with bipolar II disorder. 

Why is there confusion over whether Latuda treats or causes mania?

The reason that the topic is confusing is because Latuda is used to treat bipolar depression associated with bipolar I disorder. People with bipolar I disorder also experience mania, or manic episodes—in addition to depression, but Latuda is not FDA approved to treat mania associated with bipolar I disorder, only depression. 

To further complicate matters, Latuda’s prescribing information notes that antidepressant treatment can increase the risk of a manic or hypomanic episode, especially in people with bipolar disorder. This may seem confusing because Latuda isn’t classified as an antidepressant; it is classified as an antipsychotic. Nonetheless, it has antidepressant effects that make it effective in treating bipolar depression, and all antidepressants have the same warning about manic episodes.

Does Latuda treat or cause mania?

As mentioned above, the prescribing information for Latuda notes that there is an increased risk of a manic or hypomanic episode and that people who take Latuda should be monitored for these episodes. However, the prescribing information also notes that in clinical studies, less than 1% of people who took Latuda developed manic or hypomanic episodes.

Let’s look at the results of some research:

• A clinical trial published in 2017 looked at the safety and efficacy of Latuda. The researchers found that, of the people who took Latuda alone (without a mood stabilizer such as lithium), there was a 1.3% incidence of mania over six months. 
• A study published in 2021 found that short-term and long-term treatment with Latuda was actually associated with “significant improvement” in manic symptoms and was not associated with an increased risk of mania in either adults or children.
• A study published in 2014 found that the incidence of treatment-emergent mania was the same in people who took Latuda as in people who took placebo (inactive medicine). They noted that the severity of mania symptoms was low at the beginning of the study and had slight reductions over the course of the study.  
• A study published in 2015 also found that there was not an increased risk of mania or hypomania in people who took Latuda. 

Bottom line

The relationship between Latuda and mania can be confusing. Latuda is prescribed for depression associated with bipolar I disorder, and people with bipolar I disorder often have manic episodes. However, it may be difficult to differentiate whether manic episodes are due to the condition or the medication. 

The prescribing information notes that there may be an increased risk of manic episodes, but these episodes occurred in less than 1% of people who took Latuda. Some research has found that people who took Latuda did not have a higher risk of mania due to the medicine. 

Because everyone is different and there are so many individual factors to consider, it is important to consult your healthcare provider for more information and medical advice about your condition and the best treatment option for you.