FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W4309852380> ?p ?o ?g. }

• W4309852380 abstract "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.To assess the efficacy and safety of reducing antipsychotic dose compared to continuing the current dose for people with schizophrenia.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.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 clinically important change in quality of life, rehospitalisations and dropouts due to adverse effects; key secondary outcomes were clinically important change in functioning, relapse, dropouts for any reason, and at least one adverse effect. We also examined scales measuring symptoms, quality of life, and functioning as well as a comprehensive list of specific adverse effects. We pooled outcomes at the endpoint preferably closest to one year. We evaluated the certainty of the evidence using the GRADE approach.We included 25 RCTs, of which 22 studies provided data with 2635 participants (average age 38.4 years old). The median study sample size was 60 participants (ranging from 18 to 466 participants) and length was 37 weeks (ranging from 12 weeks to 2 years). There were variations in the dose reduction strategies in terms of speed of reduction (i.e. gradual in about half of the studies (within 2 to 16 weeks) and abrupt in the other half), and in terms of degree of reduction (i.e. median planned reduction of 66% of the dose up to complete withdrawal in three studies). We assessed risk of bias across outcomes predominantly as some concerns or high risk. No study reported data on the number of participants with a clinically important change in quality of life or functioning, and only eight studies reported continuous data on scales measuring quality of life or functioning. There was no difference between dose reduction and continuation on scales measuring quality of life (standardised mean difference (SMD) -0.01, 95% confidence interval (CI) -0.17 to 0.15, 6 RCTs, n = 719, I2 = 0%, moderate certainty evidence) and scales measuring functioning (SMD 0.03, 95% CI -0.10 to 0.17, 6 RCTs, n = 966, I2 = 0%, high certainty evidence). Dose reduction in comparison to continuation may increase the risk of rehospitalisation based on data from eight studies with estimable effect sizes; however, the 95% CI does not exclude the possibility of no difference (risk ratio (RR) 1.53, 95% CI 0.84 to 2.81, 8 RCTs, n = 1413, I2 = 59% (moderate heterogeneity), very low certainty evidence). Similarly, dose reduction increased the risk of relapse based on data from 20 studies (RR 2.16, 95% CI 1.52 to 3.06, 20 RCTs, n = 2481, I2 = 70% (substantial heterogeneity), low certainty evidence). More participants in the dose reduction group in comparison to the continuation group left the study early due to adverse effects (RR 2.20, 95% CI 1.39 to 3.49, 6 RCTs with estimable effect sizes, n = 1079, I2 = 0%, moderate certainty evidence) and for any reason (RR 1.38, 95% CI 1.05 to 1.81, 12 RCTs, n = 1551, I2 = 48% (moderate heterogeneity), moderate certainty evidence). Lastly, there was no difference between the dose reduction and continuation groups in the number of participants with at least one adverse effect based on data from four studies with estimable effect sizes (RR 1.03, 95% CI 0.94 to 1.12, 5 RCTs, n = 998 (4 RCTs, n = 980 with estimable effect sizes), I2 = 0%, moderate certainty evidence). AUTHORS' CONCLUSIONS: This review synthesised the latest evidence on the reduction of antipsychotic doses for stable individuals with schizophrenia. There was no difference between dose reduction and continuation groups in quality of life, functioning, and number of participants with at least one adverse effect. However, there was a higher risk for relapse and dropouts, and potentially for rehospitalisations, with dose reduction. Of note, the majority of the trials focused on relapse prevention rather potential beneficial outcomes on quality of life, functioning, and adverse effects, and in some studies there was rapid and substantial reduction of doses. Further well-designed RCTs are therefore needed to provide more definitive answers." @default.
• W4309852380 created "2022-11-29" @default.
• W4309852380 creator A5002251483 @default.
• W4309852380 creator A5008627361 @default.
• W4309852380 creator A5011934579 @default.
• W4309852380 creator A5027653673 @default.
• W4309852380 creator A5034467556 @default.
• W4309852380 creator A5039171231 @default.
• W4309852380 creator A5047236669 @default.
• W4309852380 creator A5051133017 @default.
• W4309852380 creator A5059852489 @default.
• W4309852380 creator A5062056789 @default.
• W4309852380 creator A5072667277 @default.
• W4309852380 date "2022-11-24" @default.
• W4309852380 modified "2023-09-23" @default.
• W4309852380 title "Antipsychotic dose reduction compared to dose continuation for people with schizophrenia" @default.
• W4309852380 cites W144058628 @default.
• W4309852380 cites W1513041145 @default.
• W4309852380 cites W1541013958 @default.
• W4309852380 cites W1591259115 @default.
• W4309852380 cites W1672654267 @default.
• W4309852380 cites W1742833546 @default.
• W4309852380 cites W176308706 @default.
• W4309852380 cites W186196019 @default.
• W4309852380 cites W1929424476 @default.
• W4309852380 cites W1963499356 @default.
• W4309852380 cites W1964162160 @default.
• W4309852380 cites W1969780646 @default.
• W4309852380 cites W1970294061 @default.
• W4309852380 cites W1970642072 @default.
• W4309852380 cites W1971058840 @default.
• W4309852380 cites W1972483922 @default.
• W4309852380 cites W1973627329 @default.
• W4309852380 cites W1973676870 @default.
• W4309852380 cites W1973798645 @default.
• W4309852380 cites W1975916217 @default.
• W4309852380 cites W1976891339 @default.
• W4309852380 cites W1977070772 @default.
• W4309852380 cites W1977185679 @default.
• W4309852380 cites W1978040764 @default.
• W4309852380 cites W1978135166 @default.
• W4309852380 cites W1978991003 @default.
• W4309852380 cites W1981015840 @default.
• W4309852380 cites W1981900418 @default.
• W4309852380 cites W1981912864 @default.
• W4309852380 cites W1983597913 @default.
• W4309852380 cites W1984233930 @default.
• W4309852380 cites W1985179715 @default.
• W4309852380 cites W1986677756 @default.
• W4309852380 cites W1987608027 @default.
• W4309852380 cites W1988430501 @default.
• W4309852380 cites W1989405621 @default.
• W4309852380 cites W1990123262 @default.
• W4309852380 cites W1991071998 @default.
• W4309852380 cites W1992857340 @default.
• W4309852380 cites W1996240273 @default.
• W4309852380 cites W1996308281 @default.
• W4309852380 cites W1999689270 @default.
• W4309852380 cites W2009832071 @default.
• W4309852380 cites W2010021697 @default.
• W4309852380 cites W2010548021 @default.
• W4309852380 cites W2011447062 @default.
• W4309852380 cites W2012190810 @default.
• W4309852380 cites W2013318842 @default.
• W4309852380 cites W2013388571 @default.
• W4309852380 cites W2013615650 @default.
• W4309852380 cites W2016773785 @default.
• W4309852380 cites W2017574928 @default.
• W4309852380 cites W2018436939 @default.
• W4309852380 cites W2018479284 @default.
• W4309852380 cites W2020424800 @default.
• W4309852380 cites W2020844317 @default.
• W4309852380 cites W2021701993 @default.
• W4309852380 cites W2023839473 @default.
• W4309852380 cites W2025250218 @default.
• W4309852380 cites W2027093916 @default.
• W4309852380 cites W2027235889 @default.
• W4309852380 cites W2029222500 @default.
• W4309852380 cites W2031716727 @default.
• W4309852380 cites W2031756259 @default.
• W4309852380 cites W2032712358 @default.
• W4309852380 cites W2033976370 @default.
• W4309852380 cites W2035887588 @default.
• W4309852380 cites W2035893722 @default.
• W4309852380 cites W2037377025 @default.
• W4309852380 cites W2040348034 @default.
• W4309852380 cites W2040982410 @default.
• W4309852380 cites W2041420077 @default.
• W4309852380 cites W2042031487 @default.
• W4309852380 cites W2042694515 @default.
• W4309852380 cites W2044383661 @default.
• W4309852380 cites W2046297324 @default.
• W4309852380 cites W2046600775 @default.
• W4309852380 cites W2048187664 @default.
• W4309852380 cites W2051155175 @default.
• W4309852380 cites W2053572731 @default.
• W4309852380 cites W2058874144 @default.
• W4309852380 cites W2062571521 @default.
• W4309852380 cites W2063674695 @default.
• W4309852380 cites W2064089743 @default.

• next