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Dose Equivalents for Antipsychotic Drugs

Filileeva O. V. 1, Mosolov S. N. 2
1PsychiatricclinicalhospitalNo. 4 P. B. Gannushkina
2Nationalmedicalresearchcenter of psychiatry and narcology V. P. Serbsky

Abstract:In clinical practice, as well as in conducting research and meta-analysis, there has long been a necessity for reliable estimates of equivalent dosages for antipsychotic drugs. According to the concept of chlorpromazine equivalents, all antipsychotics are interchangeable in accordance with their dose equivalents. In the latest reviews, the minimum effective dosages of most existing second-generation antipsychotics (SGAs) were calculated, olanzapine equivalents were listed, and the chlorpromazine equivalents of all available dosage forms were recalculated. Based on the review of the literature, the minimum effective dosages of SGAs and their olanzapine equivalents amount to: aripiprazole - 10mg/1. 33; azenapine -- 10 mg /1. 33; clozapine - 300 mg /40; haloperidol – 4 mg /0. 53; iloperidone – 8 mg /1. 07; lurasidone – 40 mg /5. 33; olanzapine – 7.5 mg /1; paliperidone – 3 mg /0. 4; quetiapine – 150 mg /20; risperidone - 2 mg /0.27; sertindole – 12 mg / 1.6; ziprasidone – 40 mg /5. 33. The following equivalent dosages were obtained using three types of statistical analysis (weighted average ratio method, direct and indirect ratio methods) 1 mg/day olanzapine: amisulpride - 38. 3 mg/day, aripiprazole - 1. 4 mg/day, azenapine - 0. 9 mg/day, chlorpromazine - 38. 9 mg/day, clozapine - 30. 6 mg/day, haloperidol - 0. 7 mg/day, quetiapine - 32. 3 mg/day, risperidone - 0. 4 mg/day, sertindole - 1. 1 mg/day, ziprasidone - 7. 9 mg/day. The olanzapine equivalents (1 mg/day) for SGA were calculated, the results amounting to: chlorpromazine - 38. 9 mg/day, chlorprothixene - 17.1 mg/day, fluphenazine 0.5 mg/day, haloperidol 0.6 mg/day, perphenazine 3.5 mg/day, thioridazine 37.1 mg/day, thrifluoperazine 1.1 mg/day. Currently, the concept of dose equivalents includes a number of methods with their own advantages and disadvantages and does not take into account the differences in the effectiveness of antipsychotics and tolerance for them, as well as their directionality. Further studies are needed, in which the method of comparing antipsychotic drugs will be improved, extrapolated to parenteral compounds, and the assessment will include not only patients with an acute schizophrenia, but other groups of patients with schizophrenia (with a predominance of negative symptoms, those resistant to therapy, in remission, experiencing the first episode, adolescents and the elderly).
Контакт: profmosolov@mail.ru

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