The researchers concluded that medical guidelines need updating.
The researchers evaluated the effect of different antipsychotic treatment strategies on the risk of relapse. Photo: shutterstock.
These results, according to the researchers’ hypothesis, contradict what is said in the current literature, that switching to another antipsychotic was as effective as continuing to take Standard dose antipsychotics.
Switching to another antipsychotic ‘does not increase the risk’ relapse. This result was not expected as previous literature indicated otherwise” Medscape Medical News The Dr. Giovanni Ostuzzifrom university Lesson gave Veronain Verona Italia.
On the other hand, reducing the dose below the standard range used in the acute phase carries Significant risk of relapse And it should be restricted to selected cases, for example cases where the risk of treatment abandonment is particularly high,” said Dr. Dr. Ostuzzi.
“These findings should provide evidence-based recommendations, bearing in mind that clinical practice for relapse prevention remains heterogeneous and is often directed only by clinical common sense,” he added.
The study was published in Lancet Psychiatry. In this sense, the authors stress that it is necessary to update clinical guidelines
The researchers evaluated the effect of different antipsychotic treatment strategies on relapse risk in a network meta-analysis of 98 randomized controlled trials involving nearly 14,000 patients.
Compared with discontinuation of antipsychotics, all continuation strategies were effective in preventing relapse.
The risk of relapse was significantly reduced, similarly, by continuing to Standard dose antipsychotics or switching to another type of antipsychotic (relative risk [RR]: 0.37 and 0.44, respectively), the researchers found.
Both strategies outperformed strategy He lowered the antipsychotic dose below the standard level (RR: 0.68), which was lower than the other two strategies.
For every three patients who continue to take a standard dose of antipsychotics, an additional patient will avoid relapse, compared to stopping antipsychotics, “which could be considered a significant effect size based on commonly used thresholds and trial results.” “Acute schizophrenia,” the researchers wrote.
Required number of patients They noted a slight increase in treatment of about 3.5 for patients who switched treatment with antipsychotics, which is “still considered to be of significant effect magnitude.”
Dr. Ostuzzi notes that “most psychiatrists currently recognize the benefits of continuing antipsychotics in clinically stable individuals. However, they may encounter the need to change the ongoing treatment strategy, usually due to side effects, poor treatment compliance, or both.” .
“Our findings support updating clinical practice guidelines to recognize that switching to other antipsychotics during prophylaxis may be as effective as continuing antipsychotics at the standard dose, with dose lower than the recommended dose. It should be limited to selected cases,” the researchers said. .
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