Lower Antipsychotic Doses May Still Prevent Schizophrenia Relapse, Study Suggests

Patients on maintenance antipsychotic treatment may not require more than 5 mg of risperidone daily (or equivalent) to keep their risk of schizophrenia relapse low, according to ameta-analysis published inJAMA Psychiatry. Doses higher than this amount may provide a little additional protection but also cause more adverse events.“Because patients often need to use antipsychotics for many years, adverse events, such as movement disorders and weight gain, can accumulate and result in even more severe problems, such as tardive dyskinesia or cardiovascular problems,” wrote Stefan Leucht, M.D., of the Technical University of Munich and colleagues. “Therefore, psychiatrists need to know which doses are sufficient for maintenance treatment. If lower doses than needed for short-term treatment were sufficient, the adverse-event burden could be substantially reduced.”Leucht and colleagues combined data from 26 placebo-controlled studies that assessed relapse prevention of antipsychotics. The collected sample encompassed 4,776 patients and the following medications: oral and LAI aripiprazole, fluphenazine LAI, oral and LAI haloperidol, oral lurasidone, oral and LAI olanzapine, paliperidone LAI, oral quetiapine, risperidone LAI, oral ziprasidone, and oral zotepine. To maintain consistency, all antipsychotic doses were converted to their equivalent dose of oral risperidone.Overall, the effectiveness of antipsychotics increased sharply at lower doses but then began to plateau. Sixty...
Source: Psychiatr News - Category: Psychiatry Tags: antipsychotics aripiprazole fluphenazine haloperidol JAMA Psychiatry lurasidone oral olanzapine oral ziprasidone paliperidone quetiapine risperidone Stefan Leucht zotepine Source Type: research