The drug is highly bound (approximately 99%) to serum proteins. Following administration of a 40-mg dose, the mean apparent volume of distribution is 6,173 (17.2) L. From 9% to 19% of the administered dose is absorbed. Peak serum concentrations (C max) and absorption occur in approximately one to three hours. The elimination half-life of the parent compound is approximately 18 hours. Steady-state concentrations are reached within seven days of initiation of therapy. Its pharmacokinetic properties are dose-proportional within a total dose of 20 to 160 mg/day. Lurasidone works primarily as a result of the activity of the parent drug. 13 Genetic and environmental risk factors contribute to the development of schizophrenia, with alterations in neurotransmitter pathways (e.g., with dopamine) and enlarged sulci and ventricles found on brain imaging. 4 Schizophrenia accounts for 2.5% of all health care expenditures, 25% of hospital beds, and 20% of all Social Security benefit days. In 2002, direct annual health care costs were estimated at $22.7 billion for the U.S., $7.6 billion in other direct costs, and $32.4 billion in lost economic productivity and caregiver costs, for a total of $62.7 billion. 11 Depressive symptoms are the most common mood disturbance in schizophrenia. 10 The combination of blunted, inappropriate, and odd expressions is the most common affective disturbance in schizophrenia. 9 All cognitive domains are also affected by the disorder, including attention, language, memory, and executive function. Negative symptoms represent a loss of affective responsiveness, verbal expression, personal motivation, enjoyment, social drive, or attention to the environment. 8 Most patients experience a combination of delusions, hallucinations, and thought disorganization.
Auditory hallucinations are the most common sensory disturbance, but visual, tactile, olfactory, and gustatory hallucinations may occur. 6, 7 Hallucinations and disorganized thinking occur in approximately 50% of these patients. Delusions are the most common psychotic symptom and occur in 65% of patients with schizophrenia. 5 Positive symptoms (psychosis) are correlated with hospital admission and a first-time diagnosis. 4įour symptom clusters have been observed in large groups of patients. 3 In the U.S., annual direct and indirect costs of the disorder total more than $62 billion. 2 Symptoms appear in men in their late teens or early 20s, whereas women are generally affected in their 20s or early 30s. A severe, chronic brain disorder, schizophrenia is characterized by an onset in early adulthood, a lifelong course, debilitating symptoms, deterioration in functional ability, and lack of social acceptability, making it among the most disabling, and economically catastrophic disorders. 1, 2 Men and women are affected with equal frequency. In a given year, approximately 2.4 million American adults, or about 1.1% of the population 18 years of age and older, have schizophrenia.