REVIEW OF: Diao X et al, Pharmaceuticals 2022;15(11):1403

STUDY TYPE: Randomized, double-blind controlled trial

We have effective medications for bipolar disorder, but one in three patients continue to experience cognitive problems even after mood stabilization. In an earlier controlled trial, lurasidone (Latuda) improved cognition in patients who were in remission from bipolar episodes. This new study looked at how lurasidone and quetiapine compared in improving cognition for young people with bipolar depression.

The independently funded study enrolled 71 young participants, ages 10–17, with bipolar depression. They were randomly given either lurasidone or quetiapine for eight weeks, using a double-blind design. The primary outcome was cognition as measured with the THINC-it app, a free computerized test that assesses processing speed, working memory, and executive functioning (available at https://progress.im/en/content/download-thinc-it%C2%AE-tool). The researchers also looked at secondary outcomes like depression and metabolic side effects. 

The study found that participants on lurasidone performed better on a test of working memory than those on quetiapine. They were faster (p=0.008) and more accurate (p=0.012) on the test. But the two groups didn’t show any significant differences on the other tests or on the secondary outcomes like depression and metabolic side effects. Because the study didn’t include a placebo group, the researchers couldn’t say for sure whether the improvements were due to the medication or some other factor.

Limitations included a small sample size from a single center, a high dropout rate, and a lack of a placebo group.

CARLAT TAKE 

Lurasidone might have a cognitive advantage over quetiapine, but we’ll wait for larger trials before jumping to that conclusion.