Objective: The dose-response relationships of antipsychotic drugs for schizophrenia are not well defined, but such information would be important for decision making by clinicians. The authors sought to fill this gap by conducting dose-response meta-analyses.
Methods: A search of multiple electronic databases (through November 2018) was conducted for all placebo-controlled dose-finding studies for 20 second-generation antipsychotic drugs and haloperidol (oral and long-acting injectable, LAI) in people with acute schizophrenia symptoms. Dose-response curves were constructed with random-effects dose-response meta-analyses and a spline model. The outcome measure was total score reduction from baseline on the Positive and Negative Syndrome Scale or the Brief Psychiatric Rating Scale. The authors identified 95% effective doses, explored whether higher or lower doses than the currently licensed ones might be more appropriate, and derived dose equivalencies from the 95% effective doses.
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The participant will review insights into the dosing of antipsychotic drugs for schizophrenia.
This program is designed for all psychiatrists in clinical practice, residents in Graduate Medical Education programs, medical students interested in psychiatry, and other physicians who wish to advance their current knowledge of clinical medicine.
Duration: 1 hour
Begin Date: April 1, 2020
End Date: March 31, 2022
In order to earn CME credit, subscribers should read through the material presented in the article. After reading the article, complete the quiz and submit your evaluation and study hours (up to 1 AMA PRA Category 1 Credit™). A score of 60% or higher is required to receive credit.
The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The APA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Title: Dose-Response Meta-Analysis of Antipsychotic Drugs for Acute Schizophrenia
Authors: Stefan Leucht, M.D., Alessio Crippa, Ph.D., Spyridon Siafis, M.D., Maxine X. Patel, M.D., Nicola Orsini, Ph.D., John M. Davis, M.D.
Affiliations: Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine, Munich (S.L., S.S.); Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London (S.L., M.X.P.); Department of Global Public Health, Karolinska Institutet, Stockholm (N.O.); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (A.C.); Department of Psychiatry, University of Illinois at Chicago, and John Hopkins School of Medicine, Baltimore (J.M.D.).
Disclosures: Dr. Leucht has received honoraria for service as a consultant or adviser and/or for lectures from Angelini, Boehringer-Ingelheim, Gedeon Richter, Janssen, Johnson & Johnson, LB Pharma, LTS Lohmann, Lundbeck, MSD, Otsuka, Recordati, Sandoz, Sanofi-Aventis, Sunovion, and TEVA. Dr. Patel has received honoraria for consulting or lectures from Boehringer-Ingelheim, Janssen, Lundbeck, Otsuka, and Sunovion. The other authors report no financial relationships with commercial interests.
Discussion of unapproved or investigational use of products*: No.
*APA policy requires disclosure by CME authors of unapproved or investigational use of products discussed in CME programs. Off-label use of medications by individual physicians is permitted and common. Decisions about off-label use can be guided by scientific literature and clinical experience.
Ned H. Kalin, M.D. (Editor-in-Chief, AJP); Carolyn Rodriguez, M.D., Ph.D. (Deputy Editor, AJP); Michael D. Roy (Editorial Director, AJP); Michael A. Pogachar (Online Content Manager, Journals). Dr. Kalin has served as a consultant to the Board of Scientific Advisors, the Pritzker Neuropsychiatric Disorders Research Consortium, and the Skyland Trail Advisory Board and as Councilor, Society of Biological Psychiatry. Dr. Rodriguez has served as a consultant to Allergan, Blackthorn, Epiodyne, and Rugen. Mr. Roy and Mr. Pogachar report no financial relationships with commercial interests.
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