Dose response and atypical antipsychotics in schizophrenia

Bruce J. Kinon, Jonna Ahl, Virginia L. Stauffer, Angela L. Hill, Peter F Buckley

Research output: Contribution to journalReview article

46 Citations (Scopus)

Abstract

Based on information from clinical trials, both the efficacy and adverse effects of conventional antipsychotics in the treatment of schizophrenia are dose related. The overlapping nature of these dose-response profiles limits the use of these agents. Atypical antipsychotics provide greater relief across the comorbid symptom domains of schizophrenia, but dose-response studies and clinical experience have revealed that some of these drugs also have dose limitations. This article reviews the dose-response relationships of the atypical antipsychotics as presented predominantly in pivotal, randomised studies (double-blind and otherwise). Limited data indicate that clozapine shows dose-related efficacy up to 600 mg/ day in patients with treatment-resistant schizophrenia. However, higher dosages of clozapine may be associated with the risk of seizures. Risperidone demonstrates dose-related adverse events that compromise efficacy. The dose-response relationships for ziprasidone, quetiapine and aripiprazole are less well established. The efficacy of olanzapine appears to be dose related within the recommended dosage range of 10-20 mg/day, but clinical trials that have explored higher dosages suggest improved efficacy. Furthermore, the higher doses are not associated with a significantly increased incidence of adverse events. Further studies are clearly needed to fully characterise the dose-response relationships of atypical antipsychotics.

Original languageEnglish (US)
Pages (from-to)597-616
Number of pages20
JournalCNS Drugs
Volume18
Issue number9
DOIs
StatePublished - Aug 2 2004

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Antipsychotic Agents
Schizophrenia
Clozapine
olanzapine
Clinical Trials
Risperidone
Double-Blind Method
Seizures
Incidence
Therapeutics
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Pharmacology (medical)

Cite this

Kinon, B. J., Ahl, J., Stauffer, V. L., Hill, A. L., & Buckley, P. F. (2004). Dose response and atypical antipsychotics in schizophrenia. CNS Drugs, 18(9), 597-616. https://doi.org/10.2165/00023210-200418090-00005

Dose response and atypical antipsychotics in schizophrenia. / Kinon, Bruce J.; Ahl, Jonna; Stauffer, Virginia L.; Hill, Angela L.; Buckley, Peter F.

In: CNS Drugs, Vol. 18, No. 9, 02.08.2004, p. 597-616.

Research output: Contribution to journalReview article

Kinon, BJ, Ahl, J, Stauffer, VL, Hill, AL & Buckley, PF 2004, 'Dose response and atypical antipsychotics in schizophrenia', CNS Drugs, vol. 18, no. 9, pp. 597-616. https://doi.org/10.2165/00023210-200418090-00005
Kinon BJ, Ahl J, Stauffer VL, Hill AL, Buckley PF. Dose response and atypical antipsychotics in schizophrenia. CNS Drugs. 2004 Aug 2;18(9):597-616. https://doi.org/10.2165/00023210-200418090-00005
Kinon, Bruce J. ; Ahl, Jonna ; Stauffer, Virginia L. ; Hill, Angela L. ; Buckley, Peter F. / Dose response and atypical antipsychotics in schizophrenia. In: CNS Drugs. 2004 ; Vol. 18, No. 9. pp. 597-616.
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