***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To examine the effectiveness of switching patients to lurasidone using 3 different dosing strategies . METHOD Adults with DSM-IV-defined schizophrenia or schizoaffective disorder in a nonacute phase of illness were r and omized to 1 of 3 lurasidone dosing regimens for the initial 2 weeks of the study : ( 1 ) 40 mg/d for 2 weeks ; ( 2 ) 40 mg/d for 1 week , increased to 80 mg/d on day 8 for week 2 ( up-titration group ) ; and ( 3 ) 80 mg/d for 2 weeks . Lurasidone was then flexibly dosed ( 40 - 120 mg/d ) for the subsequent 4 weeks of the study . The preswitch antipsychotic agent was tapered by day 7 to 50 % of the original dose and discontinued by the end of week 2 . Subjects were stratified on the basis of whether the primary preswitch antipsychotic medication was classified as " sedating " ( olanzapine or quetiapine ) or " nonsedating " ( all other antipsychotics ) . The primary outcome measure was time to treatment failure , defined as any occurrence of insufficient clinical response , exacerbation of underlying disease , or discontinuation due to an adverse event . The study was conducted from June 2010 to May 2011 . RESULTS Of 240 subjects treated in this study , 86 ( 35.8 % ) were treated with an antecedent sedating antipsychotic , and 154 ( 64.2 % ) were treated with an antecedent nonsedating antipsychotic . Nineteen ( 7.9 % ) of the 240 patients experienced treatment failure . No clinical ly relevant differences were observed when the 3 r and omized switch groups were compared . Treatment failure rates were 10/86 ( 11.6 % ) versus 9/154 ( 5.8 % ) among subjects who had been receiving a preswitch sedating versus nonsedating antipsychotic medication , respectively . Consistent with prior studies of lurasidone , there was no signal for clinical ly relevant adverse changes in body weight , glucose , insulin , lipids , or prolactin ; mean improvements in weight and lipids were observed . Movement disorder rating scales did not demonstrate meaningful changes . The incidence of akathisia as an adverse event was 12.5 % ; only 1 subject ( 0.4 % ) discontinued due to akathisia . CONCLUSIONS Switching patients to lurasidone can be successfully accomplished by starting at 40 mg/d for 2 weeks , or 80 mg/d for 2 weeks , or 40 mg/d for 1 week followed by 80 mg/d the second week . TRIAL REGISTRATION Clinical Trials.gov identifier : NCT01143077 Aripiprazole has been approved by regulatory agencies for the treatment of schizophrenia and bipolar I disorder . Although it is a dopamine partial agonist , it also has substantial binding affinity for the serotonin 5HT2A receptor . Several double-blind r and omized clinical trials have established the efficacy and tolerability of aripiprazole within the dose range of 10–30 mg/day for schizophrenia , and 15–30 mg/day for manic or mixed states associated with bipolar I disorder . Relatively few comparative trials with other second-generation antipsychotics have been published for schizophrenia , with none available for bipolar disorder . The evidence so far suggests that in terms of efficacy for schizophrenia , aripiprazole is superior to placebo and haloperidol ( long term ) , similar to perphenazine and risperidone , and inferior to olanzapine .  Its tolerability profile in patients with schizophrenia appears superior to haloperidol , perphenazine , risperidone , and olanzapine .  Efficacy in treating manic or mixed states was established in placebo-controlled trials . Among some patients with bipolar disorder  , akathisia and gastrointestinal ( GI ) complaints can emerge at the start of treatment ; however , the GI symptoms were time-limited in many instances . Appropriate dosing may also be important in individualizing therapy to improve tolerability , with lower starting doses becoming more important when adding to , or switching from , another antipsychotic . Aripiprazole appears to have a low propensity for weight gain , a favorable metabolic profile , and no association with hyperprolactinemia Rationale There is an unmet need in the treatment of schizophrenia for effective medications with fewer adverse effects . Objective This study aims to evaluate the efficacy and safety of lurasidone , an atypical antipsychotic , for the treatment of schizophrenia . Methods Patients with an acute exacerbation of schizophrenia were r and omized to 6 weeks of double-blind treatment with once-daily , fixed-dose lurasidone 40 mg ( N = 50 ) , lurasidone 120 mg ( N = 49 ) , or placebo ( N = 50 ) . The primary efficacy measure was mean change from baseline to day 42 ( last observation carried forward ) in the Brief Psychiatric Rating Scale derived ( BPRSd ) from the Positive and Negative Syndrome Scale ( PANSS ) . Results Mean change in BPRSd was significantly greater in patients receiving lurasidone 40 and 120 mg/day versus placebo ( −9.4 and −11.0 versus −3.8 ; p = 0.018 and 0.004 , respectively ) . Treatment with lurasidone 120 mg/day was superior to placebo across all secondary measures , including PANSS total ( p = 0.009 ) , PANSS positive ( p = 0.005 ) , PANSS negative ( p = 0.011 ) , and PANSS general psychopathology ( p = 0.023 ) subscales and Clinical Global Impression of Severity ( CGI-S ; p = 0.001 ) . Treatment with lurasidone 40 mg/day was superior to placebo on the PANSS positive subscale ( p = 0.018 ) and CGI-S ( p = 0.002 ) . The most common adverse events for patients receiving lurasidone were nausea ( 16.2 versus 4.0 % for placebo ) and sedation ( 16.2 versus 10.0 % for placebo ) . Minimal changes in weight , cholesterol , triglyceride , and glucose levels were observed . Conclusions In this study , which was limited by a relatively high discontinuation rate , lurasidone provided effective treatment for patients with acute exacerbation of chronic schizophrenia and had minimal effects on weight and metabolic parameters INTRODUCTION Safety and efficacy results , collected in schizophrenia and schizoaffective disorder patients treated for up to nearly 3 years , are presented for asenapine and olanzapine . RESULTS Patients completing a 52-week r and omized double-blind core study on flexible-dose asenapine ( 5 or 10 mg BID ) or olanzapine ( 10 or 20 mg QD ) could continue treatment until study blind was broken.290 patients on asenapine and 150 on olanzapine  continued treatment for variable lengths of time [ mean ± SD ( range ) 311.0 ± 146.1 ( 10 - 653 ) d and 327.4 ± 139.6 ( 15 - 631 ) d , respectively ] . Adverse event ( AE ) incidence was lower during the extension ( asenapine , 62 % ; olanzapine , 55 % ) than during the core study ( 78 % , 80 % ) . In both groups , body weight increase and incidence of extrapyramidal AEs were negligible during the extension . Mean PANSS total score changes during first year of treatment were - 37.0 for asenapine and - 35.3 for olanzapine , with further changes of 1.6 for asenapine and - 0.8 for olanzapine at the extension study endpoint . CONCLUSIONS Clinical stability on asenapine as well as olanzapine was maintained , with few recurrent or newly emerging AEs beyond 1 year of treatment BACKGROUND Improving cognitive functioning in people with schizophrenia is a major treatment goal . In addition , interview-based measures have been developed to supplement performance-based assessment s. However , few data are available regarding whether interview-based measures are sensitive to treatment-related changes . METHODS Adult out patients who met DSM-IV criteria for schizophrenia or schizoaffective disorder were r and omized to 21 days of double-blind treatment with lurasidone 120 mg once daily ( N=150 ) or ziprasidone 80 mg BID ( N=151 ) . A similar proportion of patients completed the study on lurasidone ( 67.5 % ) and ziprasidone ( 69.3 % ) . Study participants were assessed with the majority of the tests from the MATRICS Consensus Cognitive Battery ( MCCB ) and an interview-based assessment of cognitive functioning , the Schizophrenia Cognition Rating Scale ( SCoRS ) . SCoRS ratings were based on the interviewer 's best judgment , after interviews with the patient and a caregiver when available . The study was conducted from April 2006 to January 2007 . RESULTS There were no between-group treatment differences in performance on the MCCB or the SCoRS ratings .  Lurasidone patients demonstrated significant within group-improvement from baseline on the MCCB composite score ( p=0.026 ) and on the SCoRS ( p<0.001 ) , but ziprasidone patients did not improve on either the MCCB composite ( p=0.254 ) or the SCoRS ( p=0.185 ) . At endpoint there was a statistical trend ( p=0.058 ) for lurasidone to demonstrate greater improvement from baseline in SCoRS ratings . Improvements in interview-based aspects of cognition were not related to MCCB test changes , and had minimal correlations with changes in symptoms . CONCLUSIONS These data suggest that interview-based cognitive measures such as the SCoRS may be sensitive to changes after 3weeks of treatment in patients with schizophrenia . Lurasidone is being assessed further in ongoing clinical trials with additional outcome measures Despite the availability of established antipsychotic agents for the treatment of schizophrenia , continued unmet needs exist for effective medications with lower adverse-effect burden . The present study evaluated the efficacy , safety , and tolerability of treatment with the atypical antipsychotic lurasidone for patients with an acute exacerbation of schizophrenia . Patients were r and omized to 6 weeks of double-blind treatment with lurasidone 40 mg/day , 80 mg/day , or 120 mg/day , or placebo . Changes in Positive and Negative Syndrome Scale ( PANSS ) scores were evaluated using mixed-model repeated- measures ( MMRM ) analysis . Vital signs , laboratory parameters , extrapyramidal symptoms , and electrocardiogram were assessed . Treatment with lurasidone 80 mg/day result ed in significantly greater improvement in PANSS total score compared with placebo ( -23.4 versus -17.0 ; p < 0.05 ) at study endpoint ( MMRM ) ; lurasidone 40 mg/day and 120 mg/day achieved clinical ly meaningful overall PANSS score reductions from baseline ( -19.2 and -20.5 ) , but not significant separation from placebo . Differences between all lurasidone groups and placebo for changes in laboratory parameters and electrocardiographic measures were minimal . Weight gain ≥ 7 % occurred in 8.2 % of patients receiving lurasidone and 3.2 % receiving placebo . Modest increases in prolactin ( median increase , 0.7 ng/mL ) and extrapyramidal symptoms were observed following treatment with lurasidone compared with placebo . Akathisia was the most commonly reported adverse event with lurasidone ( 17.6 % , versus 3.1 % with placebo ) . In this study , in which a large placebo response was observed , lurasidone 80 mg/day , but not 40 mg/day or 120 mg/day , was statistically superior to placebo in treating acute exacerbation of chronic schizophrenia . All lurasidone doses were generally well tolerated OBJECTIVE This study was design ed to evaluate the short-term efficacy and safety of once-daily lurasidone ( 80 mg/day and 160 mg/day ) in the treatment of an acute exacerbation of schizophrenia . METHODS Participants , who were recently admitted in patients with schizophrenia with an acute exacerbation of psychotic symptoms , were r and omly assigned to 6 weeks of fixed-dose , double-blind treatment with lurasidone 80 mg ( n=125 ) , lurasidone 160 mg ( n=121 ) , quetiapine XR 600 mg ( QXR-600 mg ; n=119 ; active control included to test for assay sensitivity ) , or placebo ( n=121 ) , all dosed once daily in the evening . Efficacy was evaluated using a mixed-model repeated- measures analysis of the change from Baseline to Week 6 in Positive and Negative Syndrome Scale ( PANSS ) total score ( the primary efficacy measure ) and Clinical Global Impressions severity ( CGI-S ) 
    Output:
    
Lurasidone appears to be best in class in terms of minimizing untoward alterations in body weight and metabolic variables .
However , iloperidone , asenapine , lurasidone , and cariprazine differ among themselves in terms of on-label dosing frequency ( once daily for lurasidone and , presumably , cariprazine versus twice daily for iloperidone and asenapine ) , the need for initial titration to a therapeutic dose for iloperidone and possibly cariprazine , requirement to be taken sublingually for asenapine , requirement for administration with food for lurasidone , lengthening of the ECG QT interval ( greater for iloperidone than for asenapine and no effect observed with lurasidone ) , and adverse effects such as akathisia ( seen with cariprazine , lurasidone , and asenapine but not with iloperidone ) and sedation ( most notable with asenapine )