Antipsychotic drugs: is more worse? a meta-analysis of the published randomized control trials

Abstract

SYNOPSIS Effectiveness and side-effects of high-versus low-dose neuroleptic treatment of chronic psychosis have been assessed through a meta-analysis of 22 published randomized control trials comparing different neuroleptic doses. No incremental clinical improvement was found at doses above 375 mg equivalent of chlorpromazine, while a significant increase in adverse reactions was observed.

Dopamine and Serotonin Receptor Binding and Antipsychotic Efficacy

“…Although there are few dose-finding studies adequately powered to clearly identify minimally effective antipsychotic drug dose (Zimbroff et al, 1997), currently available data (Geddes et al, 2000;Bollini et al, 1994), as well as revisions in clinical practice, have led to a marked reduction in the average prescribed doses of most typical D 2 receptor antagonists since 1976.…”

Haloperidol blood levels and clinical outcome: a meta-analysis of studies relevant to testing the therapeutic window hypothesis

“…They point in the same direction and are consistent (12). Response to treatment was defined as a 30% improvement or more on the scales used.…”

“…(17)(18)(19) Magliozzi el al. ( Besides the above windows, we tested the following concentration ranges: [6][7][8][9][10][11][12][13][14][15][16][17][18] Median' …”

Prescribing quality improvement: reducing high‐dose antipsychotic use

“…Thus HDAT and AC should be prescribed as an exception and only after other evidence-based treatment strategies have failed. 1 HDAT and AC are associated with significant adverse effect burden including QTc prolongation, arrhythmias, sudden cardiac death, seizures, increased incidence and severity of adverse effects, longer hospital stay [3][4][5][6] and possibly increased mortality. 7 When managing a patient's mental health, they should not be exposed to higher physical health risk without a proper risk management process in place.…”