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Switching From Risperidone to Lurasidone May Reverse Some Adverse Effects

May 19, 2020

Patients who switched from risperidone to lurasidone experienced reductions in weight, waist circumference, metabolic parameters, and prolactin levels proportionate to increases experienced while on risperidone, according to a study published online in BMC Psychiatry.

“Relatively little controlled data are available on whether adverse safety effects associated with selected antipsychotics can be reversed by switching medication,” researchers wrote. “The current switch study extends the findings of the previous studies, most of which concerned the weight and metabolic benefit of switching away from olanzapine.”

The study included 223 patients with schizophrenia who completed a 12-month, double-blind study of lurasidone compared with risperidone. In an open-label study extension, all patients received 6 months of lurasidone. Patients who had been receiving risperidone switched to lurasidone treatment. 

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At the end of the initial 12-month study, risperidone treatment was associated with statistically significant increases in weight, body mass index (BMI), waist circumference, prolactin levels, glucose, and insulin, compared with treatment with lurasidone. Switching to lurasidone resulted in commensurate reductions in weight, BMI, waist circumference, glucose, and prolactin levels over the 6 months of the study extension. 

Meanwhile, long-term treatment with lurasidone over the 18 months of the original study and its extension phase had minimal effects on body weight, waist circumference, metabolic parameters, and prolactin levels, researchers reported. 

Treatment with lurasidone was generally well-tolerated over the 6-month extension, according to the study. Improvements in psychotic symptoms observed with lurasidone and risperidone during the initial 12 months were maintained during the study extension.

—Jolynn Tumolo


Mattingly GW, Haddad PM, Tocco M, et al. Switching to lurasidone following 12 months of treatment with risperidone: results of a 6-month, open-label study. BMC Psychiatry. 2020;20(1):199.

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