Antipsychotic dose reduction compared to dose continuation for people with schizophrenia

作者：Alessandro Rodolico, Spyridon Siafis, Irene Bighelli, Myrto Samara, Wulf‐Peter Hansen, Salvatore Salomone, Eugenio Aguglia, Pierfelice Cutrufelli, Ingrid Bauer, Lio Baeckers, Stefan Leucht · 发表于：Cochrane Database of Systematic Reviews · 年份：2022 · DOI：10.1002/14651858.cd014384.pub2 · 被引用次数：26 · 研究领域：Schizophrenia research and treatment、Treatment of Major Depression、Health Systems, Economic Evaluations, Quality of Life

BACKGROUND: Antipsychotic drugs are the mainstay treatment for schizophrenia, yet they are associated with diverse and potentially dose-related side effects which can reduce quality of life. For this reason, the lowest possible doses of antipsychotics are generally recommended, but higher doses are often used in clinical practice. It is still unclear if and how antipsychotic doses could be reduced safely in order to minimise the adverse-effect burden without increasing the risk of relapse. OBJECTIVES: To assess the efficacy and safety of reducing antipsychotic dose compared to continuing the current dose for people with schizophrenia. SEARCH METHODS: We conducted a systematic search on 10 February 2021 at the Cochrane Schizophrenia Group's Study-Based Register of Trials, which is based on CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, PubMed, ClinicalTrials.gov, ISRCTN, and WHO ICTRP. We also inspected the reference lists of included studies and previous reviews. SELECTION CRITERIA: We included randomised controlled trials (RCTs) comparing any dose reduction against continuation in people with schizophrenia or related disorders who were stabilised on their current antipsychotic treatment. DATA COLLECTION AND ANALYSIS: At least two review authors independently screened relevant records for inclusion, extracted data from eligible studies, and assessed the risk of bias using RoB 2. We contacted study authors for missing data and additional information. Our primary outcomes were cli...