ACUTE DEVELOPMENT OF PSYCHOSIS FOLLOWING ABRUPT DISCONTINUATION OF LURASIDONE

Switching over to different medications due to lack of response or unsatisfactory response has been a commonly used technique in all fields of medicine particularly in Psychiatry. With newer drugs getting the Food and Drug Administration (FDA) approval for various psychiatric diseases, it has become essential to become more cautious when switching over from newer drug to widely used drug. Herein, presented a case of young patient developing acute psychosis when switched over from Lurasidone (marketed with brand name Latuda by Sunovion Pharmaceuticals) 120 mg daily to Haloperidol 5 mg twice a day. Since the past two days prior to arrival to hospital, patient became very agitated, paranoid (started believing people have been following him and going to hurt him), internally preoccupied, and delusional (found walking on his knees in his house stating people following him have taken his legs below knee away; was also found pushing family out of house stating their house will catch fire soon). Patient was found hallucinating (talking and yelling at people in his room when nobody was around). After admission to inpatient psychiatry unit, we were able to stabilize patient on Risperdal with good effect. Due to Lurasidone’s long half-life of about 18-20 hours, patient presumably did not exhibit any acute behavioral changes in next couple of days. However theoretically, when receptors blocked by Lurasidone did not find enough qualitative blocking by Haloperidol, patient became acutely psychotic in next couple of days leading to hospital admission for medication stabilization.