Medication for Schizophrenia: Less is More?


#1

According to the New York Times (NYT) a week ago, a major new study found that lower doses of antipsychotics are better for the treatment of schizophrenia:

The paper, by John M. Kane and colleagues and published in the American Journal of Psychiatry (AJP), is called Comprehensive Versus Usual Community Care for First-Episode Psychosis and it presents the results of the NIMH “RAISE” study.

It’s an impressive paper. However, it’s not a paper about dose reduction. So the NYT‘s coverage was misleading.

The word “dose” (including variants such as “dosage”) appears just once in the Kane et al. paper, and that’s in reference to other studies, not the current one.

Three days ago the NYT accordingly issued a correction:

An article on Tuesday about a study of the treatment of first-episode schizophrenia referred incorrectly to the conclusions of the study. Though it studied a program intended to reduce medication dosages, the researchers do not yet know for sure if dosages were lowered or by how much.

Therefore, the study did not conclude “that schizophrenia patients who received smaller doses of antipsychotic medication and a bigger emphasis on one-on-one talk therapy and family support made greater strides in recovery.”

REad the full story here:


#2

Is 160 mg of Latuda a low dose?


#3

No - seems to be the highest dose - but that may not be a bad thing. The article above says there is no data to suggest that the lower doses were used in that big study that was recently announced - the focus really was on that fact that therapy really helped people who were already on medications.

“The recommended starting dose of LATUDA is 40 mg once daily. Initial dose titration is not required. LATUDA has been shown to be effective in a dose range of 40 mg per day to 160 mg per day [see Clinical Studies (14.1)]. The maximum recommended dose is 160 mg per day.”


#4

Thank you for the info, admin.


#5

I read this the other day.


#6

i think taking more olanzapine is more helpful then less. I had to go up on my dose. It has been effective. I also take as needed pill that i carry when i leave the house. Also taking olanzapine twice a day has helped to control my psychotic desires. I take 15 mg at night and 5 mg during the day. Then another 5 if i run into trouble. I will go up even higher if i have to. I tolerate it well. I also take 200mg lamictal and 20mg lexapro. I will do anything short of tardive dyskenia to control symptoms.


#7

Yeah I too believe a person should push themselves to be on as little as possible. I generally take about 80% to 95% of my meds. But can’t go below 80% , just too many symptoms , that ultimately interfere with what I want to do in life , on 80% of meds , there are still breakthrough symptoms , on 95% less symptoms. Above 95% side effects start to cause me problems. But I’m always trying to push that envelope, always.

That strategy would not be for everyone though…it works for me at the moment.


#8

When I was on 40 mg of Haldol a day I was practically comatose. I’d never felt so bad. Then they put me on the Haldol injection where my average daily dose was much lower. It controlled my psychosis fine. Then when they put me on Geodon and Seroquel my life became worth living again. I think lower doses of the typicals are fine, but for the atypicals you might need a higher dose.


#9

I personally feel much better now that my dose of abilify has been reduced from 10mg to 5mg!!the side effects and negative symptoms feel worse on a higher dose


#10

I am so glad this idea is starting to get explored. Thank you for finding this.