Lifelong Learning: Dose-Response Meta-Analysis of Antipsychotic Drugs for Acute Schizophrenia-View Article

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A dose-response meta-analysis found that licensed doses for antipsychotic drugs used to treat acute schizophrenia may be higher than the maximum effective doses. Bell-shaped dose-response curves for drugs like aripiprazole and risperidone suggest higher doses may not provide additional efficacy and may increase side effects. In contrast, increasing dose-response curves for drugs like lurasidone and ziprasidone indicate higher doses may be more effective. Dose equivalencies were derived for risperidone, olanzapine, and haloperidol. The study emphasizes the importance of clinicians being aware of side effects and using low doses whenever possible. The analysis has limitations including the use of aggregated data and the assumption of equal efficacy among antipsychotic drugs. Individual dosing decisions should consider drug properties, patient characteristics, and concomitant treatments. The study does not provide evidence on switching antipsychotics or determining lower dose limits.

Keywords

dose-response meta-analysis

antipsychotic drugs

acute schizophrenia

licensed doses

bell-shaped dose-response curves

side effects

lurasidone

ziprasidone

dose equivalencies

clinicians