Evidence map›Paper›PMID 39557452›Full record

SynthesisBMJ mental health2024

Efficacy and acceptability of lurasidone for bipolar depression: a systematic review and dose-response meta-analysis.

Yu-Wei Lin, Yang-Chieh Brian Chen, Kuo-Chuan Hung, Chih-Sung Liang, Ping-Tao Tseng, Andre F Carvalho, Eduard Vieta, Marco Solmi, Edward Chia-Cheng Lai, Pao-Yen Lin and 2 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMJ mental health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Yu-Wei LinDepartment of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.ORCID 0000-0001-7352-0750
Yang-Chieh Brian ChenDepartment of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Kuo-Chuan HungDepartment of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan.
Chih-Sung LiangDepartment of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.ORCID 0000-0003-1138-5586
Ping-Tao TsengProspect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan.ORCID 0000-0001-5761-7800
Andre F CarvalhoInnovation in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia.
Eduard VietaBipolar and Depressive Disorders Unit, Hospital Clinic, IDIBAPS, CIBERSAM, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
Marco SolmiDepartment of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada.ORCID 0000-0003-4877-7233
Edward Chia-Cheng LaiSchool of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Pao-Yen LinDepartment of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.ORCID 0000-0002-1394-4567
Chih-Wei HsuDepartment of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan harwicacademia@gmail.com.ORCID 0000-0002-8650-4060
Yu-Kang TuInstitute of Health Data Analytics & Statistics, College of Public Health, National Taiwan University, Taipei, Taiwan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

questionThe optimal dose of lurasidone for bipolar depression is unclear. This study examined its dose-response relationship for efficacy, acceptability, and metabolic/endocrine profiles. STUDY SELECTION AND ANALYSIS: Five databases and grey literature published until 1 August 2024, were systematically reviewed. The outcomes included efficacy (changes in depression, anxiety, clinical global impression, disability and quality of life), acceptability (dropout, manic switch, suicidality and side effects) and metabolic/endocrine profiles (changes in body weight, glucose, lipid and prolactin levels). Effect sizes were calculated using a one-step dose-response meta-analysis, expressed as standardised mean differences (SMDs), risk ratios (RRs) and mean differences (MDs) with 95% CIs.

findingsFive randomised clinical trials (2032 patients, mean treatment duration 6 weeks) indicated that the optimal therapeutic dose of lurasidone (40-60 mg) improved depression (50 mg: SMD -0.60 (95% CI -0.30, -0.89)), anxiety (50 mg: -0.32 (95% CI -0.21, -0.42)), clinical global impression (50 mg: -0.67 (95% CI -0.30, -1.03)) and disability (50 mg: -0.38 (95% CI -0.08, -0.69)). Side effects increased with higher doses (50 mg: RR 1.15 (95% CI 1.05, 1.25); 100 mg: 1.18 (95% CI 1.02, 1.36)), but dropout, manic switch and suicidality did not show a dose-effect relationship. Weight increased at doses<60 mg (40 mg: MD 0.38 (95% CI 0.16, 0.60) kg), while blood glucose levels rose at doses>70 mg (100 mg: 3.16 (95% CI 0.76, 5.57) mg/dL). Prolactin levels increased in both males (50 mg: 3.21 (95% CI 1.59, 4.84) ng/mL; 100 mg: 5.61 (95% CI 2.42, 8.81)) and females (50 mg: 6.64 (95% CI 3.50, 9.78); 100 mg: 5.33 (95% CI 0.67, 10.00)).

conclusionsA daily dose of 40-60 mg of lurasidone is a reasonable choice for bipolar depression treatment. TRIAL REGISTRATION NUMBER: INPLASY202430069.

Indexed as

Antipsychotic AgentsBipolar DisorderLurasidone HydrochlorideDose-Response Relationship, DrugHumansRandomized Controlled Trials as TopicTreatment OutcomeAntipsychotic AgentsLurasidone HydrochlorideDepressionDepression & mood disordersPSYCHIATRY

Identifiers

PMID39557452
PMCPMC11574478

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.