Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-10T06:58:47.804Z Has data issue: false hasContentIssue false
  • English
  • Français

Low-dose neuroleptic therapy and relapse in schizophrenia: meta-analysis of randomized controlled trials

Published online by Cambridge University Press:  16 April 2020

C Barbui ,
B Saraceno ,
A Liberati  and
S Garattini
C Barbui
Affiliation:
“Mario Negri” Institute for Pharmacological Research, Via Eritrea 62,20157Milan, Italy
B Saraceno
Affiliation:
“Mario Negri” Institute for Pharmacological Research, Via Eritrea 62,20157Milan, Italy
A Liberati
Affiliation:
“Mario Negri” Institute for Pharmacological Research, Via Eritrea 62,20157Milan, Italy
S Garattini
Affiliation:
“Mario Negri” Institute for Pharmacological Research, Via Eritrea 62,20157Milan, Italy
Get access

Summary

We assessed the relative efficacy and effectiveness of low-versus standard-dose neuroleptic therapy in reducing relapse rate in schizophrenic patients. Six long-term randomized controlled trials were retrieved through a MEDLINE search. A dose regimen between 50 and 100 mg equivalent of chlorpromazine, compared to a conventional one between 200 and 500 mg, was found to increase the likelihood of relapse in chronic schizophrenic patients. Differences, however, were statistically significant at 12 but not at 24 months of treatment.

Keywords

schizophrenianeurolepticslow-dosemeta-analysis
Type
Original article
Information
European Psychiatry , Volume 11 , Issue 6 , 1996 , pp. 306 - 313
Copyright
Copyright © Elsevier, Paris 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Awad, AG, Hogan, TPDiagnostic criteria as a predictor of drug response in schizophrenia Med Science Res 1988 16 199–200Google Scholar
Baldessarini, RJ, Cohen, BM, Teicher, MSignificance of neuroleptic dose and plasma level in the pharmacological treatment of psychoses Arch Gen Psychiatry 1988 45 79–91CrossRefGoogle ScholarPubMed
Baldessarini, RJ, Davis, JWhat is the best maintenance dose of neuroleptics in schizophrenia Psychiatry Res 1980 3 115–122CrossRefGoogle Scholar
Bollini, P, Pampallona, S, Orza, MJ, Adams, ME, Chalmers, TCAntipsychotic drugs: is more worse? A meta-analysis of the published randomized controlled trials Psychol Med 1994 24 307–316CrossRefGoogle Scholar
Burnett, PL, Galletly, CA, Moyle, R, Clark, CRLow-dose depot medication in schizophrenia Schizophr Bull 1993 19 155–164CrossRefGoogle Scholar
Caffey, EM, Diamond, LS, Frank, TV, et al.Discontinuation or reduction of chemotherapy in chronic schizophrenics J Chron Dis 1964 17 347–358CrossRefGoogle ScholarPubMed
Casey, DETardive diskinesia: reversible and irreversible Psychopharmacol (Berl) 1985 suppl 2 88–97Google Scholar
Cook, DJ, Sackett, DL, Spitzer, WOMethodological guidelines for systematic reviews of randomized control trials in health care from the Potsdam consultation on meta-analysis J Clin Epidem 1995 48 167–171CrossRefGoogle Scholar
Davis, JMOverview: Maintenance therapy in psychiatry: I. Schizophrenia Am J Psychiatry 1975 132 1237–1245Google ScholarPubMed
Glass, GV, McGaw, B, Smith, MLMeta-analysis in Social Research Beverly Hills,CA 1981Google Scholar
Goldstein, MJ, Rodnick, EH, Evans, JR, May, PRA, Steinberg, MRDrug and family therapy in the aftercare of acute schizophrenics Arch Gen Psychiatry 1978 35 1169–1177CrossRefGoogle ScholarPubMed
Guyatt, GH, Sackett, DL, Cook, DJUsers' guides to the medical literature. II. How to use an article about therapy or prevention JAMA 1984 271 59–63CrossRefGoogle Scholar
Hogarty, GE, McEvoy, JP, Munetz, M, et al.Dose of fluphenazine, familial expressed emotion, and outcome in schizophrenia Arch Gen Psychiatry 1988 45 797–805CrossRefGoogle Scholar
Inderbitzin, LB, Lewine, RRJ, Scheller-Gilkey, G, et al.A double-blind dose-reduction trial of fluphenazine decanoate for chronic, unstable schizophrenic patients Am J Psychiatry 1994 151 1753–1759Google ScholarPubMed
Johnson, DAWStudies of depressive symptoms in schizophrenia Br J Psychiatry 1981 139 89–101CrossRefGoogle Scholar
Johnson, DAV, Ludlow, JM, Street, K, Taylor, RDWDouble-blind comparison of half-dose and standard-dose flupenthixol decanoate in the maintenance treatment of stabilised outpatients with schizophrenia Br J Psychiatry 1987 151 634–638CrossRefGoogle Scholar
Kane, JTreatment of schizophrenia Schizophr Bull 1987 13 133–156CrossRefGoogle ScholarPubMed
Kane, J, Marder, SRPsychopharmacologic treatment of schizophrenia Schizophr Bull 1993 19 287–302CrossRefGoogle ScholarPubMed
Kane, J, Rifkin, A, Quitkin, FA pilot study of “low-dose” fluphenazine decanoate in outpatients schizophrenics Psychopharmacol Bull 1979 15 78–80Google Scholar
Kane, J, Rifkin, A, Quitkin, FFluphenazine vs placebo in patients with remitted, acute first-episode schizophrenia Arch Gen Psychiatry 1982 39 70–73CrossRefGoogle ScholarPubMed
Kane, J, Rifkin, A, Woerner, M, et al.Low-dose neuroleptic treatment of outpatients schizophrenics Arch Gen Psychiatry 1983 40 893–896CrossRefGoogle Scholar
Kane, J, Rifkin, A, Woerner, M, et al.High-dose versus low-dose strategies in the treatment of schizophrenia Psychopharmacol Bull 1985 21 533–537Google ScholarPubMed
Kane, J, Smith, JMTardive diskinesia: prevalence and risk factors, 1959 to 1979 Arch Gen Psychiatry 1982 39 473–481CrossRefGoogle Scholar
L'Abbé, KA, Detsky, AS, O'Rourke, KMeta-analysis in clinical research Ann Int Med 1987 107 224–233CrossRefGoogle ScholarPubMed
Lehmann, HE, Wilson, WH, Deutch, MMinimal maintenance medication: effects of three dose schedules on relapse rates and symptoms in chronic schizophrenic outpatients Compr Psychiatry 1983 24 293–303CrossRefGoogle ScholarPubMed
Liberati, AA plea for a more balanced view of meta-analysis and systematic overviews of the effect of health care interventions J Clin Epidemiol 1995 48 81–86CrossRefGoogle ScholarPubMed
Mantel, N, Haenszel, WStatistical aspects of the analysis of data from retrospective studies of desease J Nat Canc Inst 1959 22 719–748Google Scholar
Marder, SRDepot neuroleptics: side effects and safety J Clin Psychopharmacol 1986 6suppl 1 24S–29SCrossRefGoogle ScholarPubMed
Marder, SR, Van Putten, T, Mintz, J, Lebeil, M, McKenzie, J, May, PRALow-and conventional-dose maintenance therapy with fluphenazine decanoate Arch Gen Psychiatry 1987 44 518–521CrossRefGoogle ScholarPubMed
Marder, SR, Van Putten, T, Mintz, J, et al.Costs and benefits of two doses of fluphenazine Arch Gen Psychiatry 1984 41 1025–1029CrossRefGoogle ScholarPubMed
Marder, SR, Wirshing, WC, Van Pulten, TDrug treatment of schizophrenia: overview of recent research Schizophr Res 1991 4 81–90CrossRefGoogle ScholarPubMed
Marder, SR, Wirshing, WC, Van Putten, T, et al.Fluphenazine vs placebo supplementation for prodromal signs of relapse in schizophrenia Arch Gen Psychiatry 1994 51 280–287CrossRefGoogle Scholar
Morgenstern, H, Glazer, WM, Niedzwiecki, D, Nourjah, PThe impact of neuroleptic medication on tardive diskinesia: a meta-analysis of published studies Am J Pub Health 1987 77 717–724CrossRefGoogle Scholar
Nishikawa, T, Tsuda, A, Tanaka, M, Hoaki, Y, Koga, I, Uchida, YProphilactic effect of neuroleptics in symptom-free schizophrenics: a comparative dose-response study of haloperidol and propericiazine Psychopharmacol 1984 82 53–156CrossRefGoogle Scholar
Nishikawa, T, Tsuda, A, Tanaka, M, Koga, I, Uchida, YProphilactic effects of neuroleptics in symptom-free schizophrenics: roles of dopaminergic and noradrenergic blockers Biol Psychiatry 1985 20 1161–1166CrossRefGoogle Scholar
Oxman, AD, Cook, DJ, Guyatt, GHUsers' guides to the medical literature. IV. How to use an overview JAMA 1994 272 1367–13771CrossRefGoogle Scholar
Sacks, HS, Berrier, J, Reitman, D, Ancona-Berk, VA, Chalmers, TCMeta-analyses of randomized controlled trials New Engl J Med 1987 316 450–455CrossRefGoogle ScholarPubMed
Schooler, NRMaintenance medication for schizophrenia: strategies for dose reduction Schizophr Bull 1991 17 311–324CrossRefGoogle ScholarPubMed
Schooler, NRReducing dosage in maintenance treatment of schizophrenia Br J Psychiatry 1993 163suppl 22 58–65CrossRefGoogle Scholar
Tantam, D, McGrath, GProlonged use of neuroleptics in schizophrenia: a review for the practitioner Int Clin Psychopharmacol 1989 4 167–194CrossRefGoogle ScholarPubMed
Van Putten, T, May, PRAAkinetic depression in schizophrenia Arch Gen Psychiatry 1978 35 1101–1107CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.