AUTHOR=Qian Li , Xuemei Liao , Jitao Li , Yun'Ai Su , Tianmei Si 

TITLE=Dose-Dependent Efficacy of Aripiprazole in Treating Patients With Schizophrenia or Schizoaffective Disorder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

JOURNAL=Frontiers in Psychiatry

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.717715

DOI=10.3389/fpsyt.2021.717715

ISSN=1664-0640

ABSTRACT=<p><bold>Purpose:</bold> To compare the efficacy and tolerability of different administration strategies of aripiprazole.</p><p><bold>Methods:</bold> We searched MEDLINE, EMBASE, the Cochrane Central, Web of Science, China National Knowledge Infrastructure(CNKI), and Wanfang Data Knowledge Service Platform(Wanfang) for randomized controlled trials (RCTs) of aripiprazole, using the terms: (aripiprazole) AND (schizophr<sup>*</sup> OR schizoaff<sup>*</sup>) AND (“syndrome scale” OR PANSS) AND (clini<sup>*</sup> OR trial). We retrieved study design, participant characteristics, comparison groups, and outcomes from each study.</p><p><bold>Results:</bold> In total, nine RCTs were selected for meta-analysis, which covered ~1,187 participants. We defined two treatment groups that represent different treatment strategies: (1) the high-dose group (the high-dose strategy) rapidly increased to doses higher than 15 mg/day in 2 weeks or began with doses higher than 15 mg/day, otherwise the group was defined as (2) the low-dose group (the low-dose strategy). If the initial or target doses of aripiprazole in a study were all higher than 15 mg/day, the high- and low-dose groups were created based on the relative level of the dose. The high-dose group showed significantly greater reductions in Positive and Negative Syndrome Scale (PANSS) total scores (standardized mean differences = −8.31, 95% confidence interval [CI] = −16.48, −0.13; <italic>P</italic> &lt; 0.01; <italic>I</italic><sup>2</sup> = 96%) than the low-dose group. The high-dose group showed superior effects compared with the low-dose group in long-term studies (more than 8 weeks) (standardized mean differences = −13.81, 95% CI = −25.07, −2.55; <italic>P</italic> &lt; 0.01; <italic>I</italic><sup>2</sup> = 96%). With exception of somnolence, we did not find significant differences in side effects or discontinuation due to adverse events. Sensitivity analyses produced similar results.</p><p><bold>Conclusion:</bold> The high-dose treatment strategy of aripiprazole for patients with schizophrenia or schizoaffective disorder may bring more benefits without obvious side effects.</p>