Latuda vs. lithium: Differences, similarities & side effects

In this article:

• Latuda vs. lithium: Key differences
• Latuda vs. lithium: Conditions treated
• Can you take Latuda and lithium together?
• Latuda vs. lithium: Insurance coverage and cost comparison
• Latuda vs. lithium side effects
• Latuda and lithium drug interactions
• Latuda and lithium drug warnings

In this article

• Latuda vs. lithium: Key differences
• Latuda vs. lithium: Conditions treated
• Can you take Latuda and lithium together?
• Latuda vs. lithium: Insurance coverage and cost comparison
• Latuda vs. lithium side effects
• Latuda and lithium drug interactions
• Latuda and lithium drug warnings

Latuda (lurasidone) and lithium are two prescription drugs used to treat bipolar disorder. Latuda is an atypical antipsychotic that can be prescribed alone (monotherapy) or with another drug (adjunctive therapy) to improve depressive episodes in people with bipolar I disorder. It’s also approved by the Food and Drug Administration (FDA) to treat schizophrenia. Lithium is an antimanic agent that can reduce the frequency and intensity of manic episodes associated with bipolar I disorder.  

Though both Latuda and lithium help treat disorders associated with mental health, they have notable differences in ingredients, indications, and cost. 

Latuda vs. lithium: Key differences

Although their uses overlap, Latuda and lithium are both prescribed to treat bipolar disorder. They are very different medications. One cannot be swapped for the other.

Latuda and lithium belong to completely different drug classes. “Latuda is an antipsychotic, whereas lithium is a conventional mood stabilizer,” explains psychiatrist Sid Khurana, MD, the medical director and co-founder of Nevada Mental Health. This means that they have different mechanisms of action and, ultimately, different purposes.

Latuda is a brand-name prescription medication that helps balance serotonin and dopamine levels. It is used to treat both schizophrenia and bipolar depression associated with bipolar I disorder. 

Lithium is a generic antimanic agent that helps regulate mood, which means it can help with both depression and mania associated with bipolar disorder. It has also been on the market for much longer than Latuda, so it tends to be much more affordable. It is available as a tablet, capsule, extended-release tablet, and a solution (liquid) taken by mouth. 

Dr. Khurana warns that lithium dosage can be tricky. “We have to make sure the levels are just right because going above can be toxic, and if they are too low, it could be ineffective,” he explains.

People with bipolar disorder experience intense mood swings. Latuda may help improve the “lows” of bipolar disorder, while lithium helps regulate the “highs”—and, in some cases, also the lows.

Latuda vs. lithium: Comparing key differences
	Latuda	Lithium
Drug class	Mood stabilizer, antipsychotic	Mood stabilizer, antimanic
Brand/generic status	Brand	Generic
What is the generic or brand name?	Generic: lurasidone	Brand names: Lith-Oro, Lithobid
What form(s) does the drug come in?	Tablet	Capsule, liquid, tablet, long-acting tablet
What is the standard dosage?	20 or 40 mg tablet once daily	Varies; different forms of lithium have different doses
How long is the typical treatment?	Long-term maintenance	Long-term maintenance
Who typically uses the medication?	Adults, adolescents, and children 10 years and older	Adults, adolescents, and children 7 years and older

 

Latuda vs. lithium: Conditions treated

Through rigorous clinical trials and documentation, the FDA approves medications for very specific uses. When considering Latuda versus lithium, it’s important to differentiate between bipolar I disorder and bipolar II disorder, as these medications are not FDA approved to treat both.

“Bipolar depression is [a criterion] for the diagnosis of both bipolar I and bipolar II disorder,”  explains Carla Marie Manly, Ph.D., a clinical psychologist and author of Joy from Fear. “Bipolar I involves the occurrence of a manic episode, and bipolar II involves the occurrence of a hypomanic episode.”

Latuda is FDA approved to treat depression associated with bipolar I disorder in adults and children ages 10 years and older. It is also approved for the treatment of schizophrenia in adults and young adults ages 13 years and older.

Lithium is FDA approved to treat acute manic episodes and mixed episodes of bipolar I disorder in adults and children ages 7 years and older. It is also FDA approved as a bipolar I disorder maintenance treatment for patients 7 years and older. 

Those are the FDA-approved uses, or indications, for Latuda and lithium. However, some doctors prescribe Latuda off-label for depression or depressive episodes in bipolar II disorder.

“[Lithium] can also be used in other conditions like depression,” says Dr. Khurana. “Lithium works really well for mood stabilization.” 

Latuda vs. lithium: Comparing conditions treated
Condition	Latuda	Lithium
Bipolar I disorder	Yes	Yes
Manic episodes associated with bipolar disorder	No	Yes
Bipolar depression	Yes	No
Schizophrenia	Yes	No
Major depressive disorder	Off-label	Off-label
Bipolar II disorder	Off-label	No

 

Can you take Latuda and lithium together?

Yes, taking Latuda and lithium together is a safe treatment option. They treat different symptoms of bipolar disorder, so they can be used as monotherapies or as adjunctive (supplementary) therapies to one another.

“While a physician may prescribe lithium to treat general symptoms of bipolar disorder, another psychopharmaceutical [such as Latuda] may be prescribed specifically for depressive episodes,” Dr. Manly says.

A placebo-controlled trial published in European Neuropsychopharmacology in 2017 found that long-term treatment with a combination of lithium and lurasidone, which is sold under the brand name Latuda, was safe and well-tolerated in people with bipolar disorder.

Latuda vs. lithium: Insurance coverage and cost comparison

Without insurance, Latuda costs about $1,858.91 for 30, 40 mg tablets, and lithium carbonate costs about $28.23 for 90, 300 mg capsules. However, drug costs vary depending on your insurance plan and pharmacy used. Check with your health insurance company or Medicare Part D plan for information on out-of-pocket costs for these drugs. 

You can save money on these prescription medications with SingleCare. A SingleCare coupon can reduce the cash price of a one-month supply of brand-name Latuda to $1,375 and the price of lurasidone (generic Latuda) to $22.28. For lithium carbonate, you could pay $2.54 for 90, 300 mg capsules.

Latuda vs. lithium: Comparing insurance & cost
	Latuda	Lithium
Typically covered by insurance?	Usually	Usually
Typically covered by Medicare Part D?	Yes	Yes
Quantity	30, 40 mg tablets	90, 300 mg capsules
SingleCare cost of generic drugs	$22.28	$2.54

 

Latuda vs. lithium side effects

The most common side effect of both Latuda and lithium is nausea. After that, common side effects of Latuda include drowsiness, muscle stiffness, and trouble sleeping. Common side effects of lithium include feeling thirsty, increased urine output, and tremors.

As for potentially worrisome side effects, Latuda may cause metabolic issues, while lithium may affect certain organs. “With Latuda, we mostly watch for cholesterol, glucose, and weight gain,” Dr. Khurana says. “Whereas lithium can be harsh on the kidneys and the thyroid, so we monitor those levels very closely.”

When considering Latuda versus lithium, it’s a good idea to seek medical advice about all possible side effects, from mild to moderate to severe.

Latuda vs. lithium: Comparing side effects
	Latuda (40 mg)		Lithium (from a study with daily doses ranging from 300 to 3,600 mg)
Side effect	Applicable?	Frequency	Applicable?	Frequency
Nausea/vomiting	Yes	6-10%	Yes	57%
Dyspepsia (indigestion)	Yes	6%	No	—
Back pain	Yes	4%	No	—
Drowsiness/Fatigue	Yes	16%	Yes	26%
Akathisia (urge to move)	Yes	11%	No	—
Extrapyramidal disorder (muscle stiffness, uncontrolled movements)	Yes	11%	No	—
Dizziness	Yes	4%	Yes	23%
Insomnia	Yes	10%	No	—
Agitation	Yes	7%	No	—
Anxiety	Yes	6%	No	—
Excessive urination	No	—	Yes	38%
Increased thyroid-stimulating hormone (TSH) levels	No	—	Yes	25%
Thirst	No	—	Yes	28%
Decreased appetite	No	—	Yes	9%
Ataxia (gait disturbance)	No	—	Yes	13%
Blurry vision	No	—	Yes	9%
Disorientation	No	—	Yes	6%
Tremors	No	—	Yes	32%
Rash	No	—	Yes	13%

Source: DailyMed (Latuda/lithium)

Latuda and lithium drug interactions

Some medicines should not be mixed with Latuda or lithium. Other medications can be safely combined, but they require prescribers to adjust the dosage. 

Mixing Latuda or lithium with other drugs that increase serotonin may cause serotonin syndrome—a dangerous condition that occurs when too much serotonin builds up in the body. Symptoms of serotonin syndrome include agitation, disorientation, loss of muscle coordination, fever, and others.  

Latuda is metabolized in the liver by an enzyme called CYP3A4. Drugs classified as CYP3A4 inhibitors or inducers may impact the level of Latuda in a person’s bloodstream. Mixing Latuda with a CYP3A4 inhibitor may increase the level of Latuda in the body, thus increasing the risk of side effects. Mixing Latuda with CYP3A4 inducers may speed up the metabolism of Latuda, making it less effective. 

Prescribing information for Latuda also cautions to avoid grapefruit or grapefruit juice while taking this medication. Grapefruit-drug interactions are common, so it’s a good idea to ask your pharmacist about it whenever you take a new medicine. 

The following is an incomplete list of the drugs that may interact with Latuda, lithium, or both. Always check with your pharmacist or healthcare provider about possible drug interactions.

Latuda vs. lithium: Comparing drug interactions
Drug	Drug class	Latuda	Lithium
Hydrochlorothiazide, chlorthalidone, indapamide	Diuretics	No	Yes
Advil, ibuprofen, Aleve	Nonsteroidal anti-inflammatory drugs (NSAIDs)	No	Yes
Atacand, candesartan-cilexetil, Avapro	Angiotensin receptor blockers (ARBs)	No	Yes
Flagyl (metronidazole)	Antibiotic	No	Yes
Fluoxetine, citalopram, escitalopram, fluvoxamine,paroxetine, vortioxetine, vilazodone, sertraline	Selective serotonin reuptake inhibitors (SSRIs)	Yes	Yes
Chlorpromazine, fluphenazine, haloperidol, loxapine, pimozide, olanzapine, quetiapine, cariprazine	Antipsychotics	No	Yes
Ketoconazole, fluconazole, clarithromycin, erythromycin, ritonavir, diltiazem, verapamil	CYP3A4 inhibitors	Yes	No
Rifampin, phenytoin, carbamazepine, efavirenz, etravirine, St. John’s Wort	CYP3A4 inducers	Yes	No
Amlodipine, lisinopril, losartan	Antihypertensives	Yes	No

 

Latuda and lithium drug warnings

When comparing Latuda and lithium, it’s important to know that these medications are not suitable for everyone. 

Some people experience an increase in depression and suicidal thoughts while taking antipsychotic drugs, antidepressants, or other mood stabilizers. It’s important to monitor for signs of worsening mental illness while taking either of these medications. 

Latuda should not be taken for depressive symptoms of dementia-related psychosis in older adults with dementia. Latuda is not FDA approved for treating depression in this population, as the drug may increase the risk of death.

As Dr. Khurana stated, lithium dosages should be closely monitored. This drug can be toxic at high doses. A National Library of Medicine warning emphasizes that people taking lithium should keep and attend all of their appointments with their healthcare providers, as well as laboratory appointments.

Both medications have boxed warnings (also known as black box warnings). Latuda’s boxed warning is about suicidal thoughts and behaviors, and lithium’s boxed warning is about lithium toxicity—a life-threatening condition that can cause intestinal and neurological symptoms.

Thoroughly discuss your family medical history, personal medical history, other health conditions, and other prescription drugs and daily supplements with a healthcare provider before starting either of these medications. Also, never discontinue Latuda or lithium without seeking guidance from a psychiatric medical provider. 

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