Comparison of efficacy and safety between once-daily dosing and divided dosing of antipsychotic drugs in patients with schizophrenia: a systematic review
Keywords:
antipsychotic, divided dosing, once daily dosing, schizophreniaAbstract
Objective: To perform systematic review on the efficacy and safety of once-daily dosing in comparison with divided dosing of antipsychotic drugs in patients with schizophrenia.
Methods: PubMed, EMBASE and Cochrane Library databases were searched for relevant studies using PICO framework, the quality of evidences were assessed by two authors independently using the Cochrane Collaboration’s tool for RCT studies and Newcastle Ottawa Scales for cross-sectional studies, any discordances were resolved by a consensus with the third author. The result of study was presented in compliance with PRISMA guideline.
Results: Seven studies (N = 2,224), including six randomized controlled trials (N = 1,240) and a cross-sectional study (N = 984) met the inclusion criteria. Most of the studies that evaluated the effect of risperidone (N = 596), quetiapine (N = 21), perphenazine (N = 257) and clozapine (N = 984) found no difference on the efficacy and safety between once-daily and divided-dosing of antipsychotic. However, in the study using olanzapine, less adverse effects were reported with once-daily dosing, similar to a study of asenapine that reported better outcome and less adverse effects with once-daily dosing.
Conclusion: This systematic review found no inferiority in the efficacy and safety of once-daily doing compared with divided dosing of antipsychotics in patients with schizophrenia. However, a patient with acute or severe psychosis should follow the specific drugs recommendation for doses administration.
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