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Halved Dose of Antipsychotics Versus High-Dose Antipsychotic Therapy for Relapse in Patients with Schizophrenia Receiving High-Dose Antipsychotic Therapy: A Randomized Single-Blind Trial.

作者信息

Ataniya Ryota, Koike Takeshi, Inamoto Atsuko

机构信息

Showa University Northern Yokohama Hospital, 35-1, Chigasakichuou, Tsuzuki-Ku, Yokohama-Shi 224-0032, Japan.

Department of Psychiatry, Edogawa Hospital, 2702, Yamazaki, Noda-Shi 278-0022, Japan.

出版信息

Int J Mol Sci. 2025 Apr 23;26(9):4003. doi: 10.3390/ijms26094003.


DOI:10.3390/ijms26094003
PMID:40362244
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12071691/
Abstract

Both a shortage and an excess of dopamine (DA) in the prefrontal cortex and striatum result in their decreased functions, and the relationship between the DA levels and their functions exhibits an inverted-U shape. Increased DA transmission via dose reduction in the currently used antipsychotics may improve the activation of DA-related symptoms in schizophrenia; these include delusions and auditory hallucinations caused by increased DA release. In this case, reducing the dose of the antipsychotic may be a treatment option for relapse in patients with schizophrenia who are already on high doses of antipsychotics and find it difficult to further increase the dose. A total of 54 inpatients with schizophrenia receiving high-dose antipsychotic therapy were randomly assigned to either the halved-dose group or the high-dose group (symptomatic treatment). The study compared the time from relapse to improvement between the two groups. In the halved-dose group, the period until relapse improvement ranged from 1 to 3 weeks, while the high-dose group experienced improvement in 4 to 9 weeks, and a significant difference was observed between the two groups using Kaplan-Meier survival analysis ( < 0.001).

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e698/12071691/87842335df88/ijms-26-04003-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e698/12071691/4f41bb984898/ijms-26-04003-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e698/12071691/e56c334a5bd6/ijms-26-04003-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e698/12071691/73db7b59840d/ijms-26-04003-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e698/12071691/87842335df88/ijms-26-04003-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e698/12071691/4f41bb984898/ijms-26-04003-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e698/12071691/e56c334a5bd6/ijms-26-04003-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e698/12071691/73db7b59840d/ijms-26-04003-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e698/12071691/87842335df88/ijms-26-04003-g004.jpg

相似文献

[1]
Halved Dose of Antipsychotics Versus High-Dose Antipsychotic Therapy for Relapse in Patients with Schizophrenia Receiving High-Dose Antipsychotic Therapy: A Randomized Single-Blind Trial.

Int J Mol Sci. 2025-4-23

[2]
Standard versus reduced dose of antipsychotics for relapse prevention in multi-episode schizophrenia: a systematic review and meta-analysis of randomised controlled trials.

Lancet Psychiatry. 2021-6

[3]
Paliperidone palmitate versus oral antipsychotics in recently diagnosed schizophrenia.

Schizophr Res. 2015-12

[4]
Continuing, reducing, switching, or stopping antipsychotics in individuals with schizophrenia-spectrum disorders who are clinically stable: a systematic review and network meta-analysis.

Lancet Psychiatry. 2022-8

[5]
Antipsychotic medication versus psychological intervention versus a combination of both in adolescents with first-episode psychosis (MAPS): a multicentre, three-arm, randomised controlled pilot and feasibility study.

Lancet Psychiatry. 2020-9

[6]
Antipsychotic drugs versus cognitive behavioural therapy versus a combination of both in people with psychosis: a randomised controlled pilot and feasibility study.

Lancet Psychiatry. 2018-5

[7]
Reducing antipsychotic drugs in stable patients with chronic schizophrenia or schizoaffective disorder: a randomized controlled pilot trial.

Eur Arch Psychiatry Clin Neurosci. 2021-3

[8]
Randomised controlled trial of gradual antipsychotic reduction and discontinuation in people with schizophrenia and related disorders: the RADAR trial (Research into Antipsychotic Discontinuation and Reduction).

BMJ Open. 2019-11-27

[9]
Maintenance treatment with risperidone or low-dose haloperidol in first-episode schizophrenia: 1-year results of a randomized controlled trial within the German Research Network on Schizophrenia.

J Clin Psychiatry. 2007-11

[10]
Evaluation of Antipsychotic Dose Reduction in Late-Life Schizophrenia: A Prospective Dopamine D2/3 Receptor Occupancy Study.

JAMA Psychiatry. 2015-9

本文引用的文献

[1]
Schizophrenia, Dopamine and the Striatum: From Biology to Symptoms.

Trends Neurosci. 2019-1-6

[2]
Overexpression of striatal D2 receptors reduces motivation thereby decreasing food anticipatory activity.

Eur J Neurosci. 2020-1

[3]
Dopamine neurons create Pavlovian conditioned stimuli with circuit-defined motivational properties.

Nat Neurosci. 2018-7-23

[4]
Striatal Local Circuitry: A New Framework for Lateral Inhibition.

Neuron. 2017-10-11

[5]
Elevated Striatal Dopamine Function in Immigrants and Their Children: A Risk Mechanism for Psychosis.

Schizophr Bull. 2017-3-1

[6]
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Am J Psychiatry. 2017-3-1

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Biol Psychiatry. 2017-1-1

[8]
The functional logic of corticostriatal connections.

Brain Struct Funct. 2017-3

[9]
Dopamine Regulation of Lateral Inhibition between Striatal Neurons Gates the Stimulant Actions of Cocaine.

Neuron. 2016-6-1

[10]
Adaptive Prediction Error Coding in the Human Midbrain and Striatum Facilitates Behavioral Adaptation and Learning Efficiency.

Neuron. 2016-6-1

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