Efficacy of lurasidone in the treatment of agitation: A post hoc analysis of five short-term studies in acutely ill patients with schizophrenia

Objective: This post hoc analysis evaluated the effect of lurasidone on agitation in acutely ill patients with schizophrenia. Method: Patient-level data were pooled from five 6-week, randomized, double-blind, placebo-controlled studies of fixed-dose, once-daily, oral lurasidone (40, 80, 120, or 160 mg/d). Agitation was assessed with the Positive and Negative Syndrome Scale-Excited Component (PANSS-EC) score, utilizing a mixed model for repeated measurement analysis. Results: In patients with higher levels of agitation at baseline (PANSS-EC score >= 14; n = 773), lurasidone was associated with significantly greater improvement in least-squares (LS) mean PANSS-EC scores versus placebo at Day 3/4 (-1.6 vs-1.0; p < 0.05), Day 7 (-2.3 vs-1.6; p < 0.05), and at Week 6 endpoint (-5.5 vs-3.8; p < 0.001; effect size = 0.43). In patients with lower agitation at baseline (PANSS-EC score < 14; n = 754), LS mean PANSS-EC score change was significantly greater for lurasidone compared with placebo at Day 7 (-0.8 vs -0.1; p < 0. 01) through Week 6 endpoint (-1.9 vs -0.9; p < 0.001; effect size = 0.31). Higher doses of lurasidone were notably more effective than lower doses in patients with more severe agitation at study baseline. Conclusion: In this pooled analysis of 5 short-term studies, lurasidone provided early and sustained reduction in agitation, assessed using the PANSS-EC score, in patients with an acute exacerbation of schizophrenia. Higher doses of lurasidone were particularly effective in patients with more severe agitation at study baseline. Overall, these results suggest that lurasidone may be a useful treatment option for patients exhibiting agitation associated with acute psychotic symptoms of schizophrenia.