Commentary

Lurasidone: classification and indications


 

The authors of “Atypical antipsychotics during pregnancy” (Current Psychiatry, July 2013, pp. 12-18) incorrectly state that all atypical antipsychotics are FDA Pregnancy Category C except for clozapine. In fact, lurasidone (Latuda) is FDA Pregnancy Category B. I was disappointed that the authors did not address this distinction; I find it puzzling why such a new medication, with such little data available, was able to obtain a FDA Pregnancy Category B label.

Laura Gilley, MD
Child and Adolescent Psychiatrist
Clinical Instructor

University of Utah
Salt Lake City, Utah

Drs. Robakis and Williams share clinically relevant information on an important issue in “Atypical antipsychotics during pregnancy.” For the most part, their information is current, but some facts need to be updated: Notably, olanzapine is now approved for use in the treatment of bipolar I disorder in children age 13 to 171 and paliperidone also is approved for the treatment of schizophrenia in children age 12 to 17.2

As we move forward with development of novel drugs, we will, I hope, create safer options for pregnant patients. Until then, clinically useful discussions of available evidence and risk/benefit analyses are greatly appreciated.

Deepak Prabhakar, MD, MPH
Attending Psychiatrist
Behavioral Health Services
Henry Ford Health System
Detroit, Michigan

References

1. Christian R, Saavedra L, Gaynes BN, et al. Future research needs for first- and second-generation antipsychotics for children and young adults. http://effectivehealthcare.ahrq.gov/ehc/products/147/835/CER39_Antipsychotics-Children-Young-Adults_20120221.pdf. Accessed August 13, 2012.

2. Invega {package insert}. Titusville, NJ: Janssen Pharmaceuticals Inc.; 2013.

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