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Lurasidone + lithium or divalproex is a combination therapy used primarily for the treatment of depressive episodes associated with bipolar I disorder in adults. Lurasidone is an atypical antipsychotic that acts as an antagonist at dopamine D2 receptor and serotonin 5-HT2A and 5-HT7 receptors and as a partial agonist at serotonin 5-HT1A receptor. It has negligible affinity for histamine H1 and muscarinic M1 receptors. Lithium is a mood stabilizer with complex mechanisms involving modulation of neurotransmitter release and second messenger systems. Divalproex (valproate) is also a mood stabilizer that increases brain concentrations of gamma-aminobutyric acid (GABA). The combination of lurasidone with either lithium or divalproex has been shown to be more effective than placebo in treating bipolar depression, with minimal effects on weight gain or metabolic parameters[2][3][4][6]. Lurasidone was approved by the FDA for use as adjunctive therapy to lithium or valproate in bipolar depression.
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