{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T16:33:38Z","timestamp":1772555618356,"version":"3.50.1"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T00:00:00Z","timestamp":1628640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:p><jats:bold>Purpose:<\/jats:bold> To compare the efficacy and tolerability of different administration strategies of aripiprazole.<\/jats:p><jats:p><jats:bold>Methods:<\/jats: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<jats:sup>*<\/jats:sup> OR schizoaff<jats:sup>*<\/jats:sup>) AND (\u201csyndrome scale\u201d OR PANSS) AND (clini<jats:sup>*<\/jats:sup> OR trial). We retrieved study design, participant characteristics, comparison groups, and outcomes from each study.<\/jats:p><jats:p><jats:bold>Results:<\/jats: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 = \u22128.31, 95% confidence interval [CI] = \u221216.48, \u22120.13; <jats:italic>P<\/jats:italic> &amp;lt; 0.01; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats: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 = \u221213.81, 95% CI = \u221225.07, \u22122.55; <jats:italic>P<\/jats:italic> &amp;lt; 0.01; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats: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.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> The high-dose treatment strategy of aripiprazole for patients with schizophrenia or schizoaffective disorder may bring more benefits without obvious side effects.<\/jats:p>","DOI":"10.3389\/fpsyt.2021.717715","type":"journal-article","created":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T05:47:26Z","timestamp":1628660846000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Dose-Dependent Efficacy of Aripiprazole in Treating Patients With Schizophrenia or Schizoaffective Disorder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials"],"prefix":"10.3389","volume":"12","author":[{"given":"Li","family":"Qian","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liao","family":"Xuemei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Jitao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su","family":"Yun'Ai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Si","family":"Tianmei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,8,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1517\/14656566.2015.1013029","article-title":"Switching antipsychotic medication to aripiprazole: position paper by a panel of Italian psychiatrists","volume":"16","author":"Fagiolini","year":"2015","journal-title":"Exp Opin Pharmacother"},{"key":"B2","doi-asserted-by":"publisher","first-page":"S21","DOI":"10.1055\/s-2006-931485","article-title":"Aripiprazole: pharmacodynamics of a dopamine partial agonist for the treatment of schizophrenia","volume":"39","author":"Gr\u00fcnder","year":"2006","journal-title":"Pharmacopsychiatry"},{"key":"B3","doi-asserted-by":"publisher","first-page":"763","DOI":"10.4088\/JCP.v63n0903","article-title":"Efficacy and safety of aripiprazole and haloperidol versus placebo in patients with schizophrenia and schizoaffective disorder","volume":"63","author":"Kane","year":"2002","journal-title":"J Clin Psychiatry"},{"key":"B4","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1001\/archpsyc.60.7.681","article-title":"Aripiprazole, an antipsychotic with a novel mechanism of action, and risperidone vs placebo in patients with schizophrenia and schizoaffective disorder","volume":"60","author":"Potkin","year":"2003","journal-title":"Arch Gen Psychiatry"},{"key":"B5","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1017\/S1461145703003651","article-title":"Efficacy and safety of aripiprazole vs. haloperidol for long-term maintenance treatment following acute relapse of schizophrenia","volume":"6","author":"Kasper","year":"2003","journal-title":"Int J Neuropsychopharmacol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.4088\/JCP.v64n0910","article-title":"Aripiprazole for the prevention of relapse in stabilized patients with Chronic Schizophrenia: a placebo-controlled 26-week study","volume":"64","author":"Pigott","year":"2003","journal-title":"J Clin Psychiatry"},{"key":"B7","article-title":"Abilify\u00ae (aripiprazole) tablets [prescribing information]","year":"2020"},{"key":"B8","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1111\/pcn.12631","article-title":"Comparative analysis of the effects of different doses of aripiprazole on schizophrenia","volume":"19","author":"Zhu","year":"2019","journal-title":"Worlds Latest Med Inf Dig"},{"key":"B9","first-page":"972","article-title":"Comparison of the effects of different doses of aripiprazole in the treatment of chronic schizophrenia","volume":"19","author":"Cheng","year":"2018","journal-title":"J Chronic Dis."},{"key":"B10","first-page":"131","article-title":"Analysis of curative effect of different usage of aripiprazole on chronic schizophrenia","volume":"29","author":"Xu","year":"2016","journal-title":"J Psychiatry"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1432","DOI":"10.1176\/appi.ajp.2008.07061035","article-title":"A multiple-center, randomized, double-blind, placebo-controlled study of oral aripiprazole for treatment of adolescents with schizophrenia","volume":"165","author":"Findling","year":"2008","journal-title":"Am J Psychiatry"},{"key":"B12","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.schres.2017.08.012","article-title":"Rapid vs. slow antipsychotic initiation in schizophrenia: a systematic review and meta-analysis","volume":"193","author":"Takeuchi","year":"2018","journal-title":"Schizophr Res"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.1517\/14656566.9.8.1279","article-title":"Proposed strategies for successful clinical management with aripiprazole","volume":"9","author":"Mago","year":"2008","journal-title":"Expert Opin Pharmacother"},{"key":"B14","doi-asserted-by":"publisher","first-page":"b2700","DOI":"10.1136\/bmj.b2700","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration","volume":"339","author":"Liberati","year":"2009","journal-title":"BMJ"},{"key":"B15","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1093\/schbul\/13.2.261","article-title":"The Positive and Negative Syndrome Scale (PANSS) for Schizophrenia","volume":"13","author":"Kay","year":"1987","journal-title":"Schizophr Bull"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1624","DOI":"10.4088\/JCP.v65n1207","article-title":"Efficacy and tolerability of ziprasidone versus risperidone in patients with acute exacerbation of schizophrenia or schizoaffective disorder: an 8-week, double-blind, multicenter trial","volume":"65","author":"Addington","year":"2004","journal-title":"J Clin Psychiatry"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1093","DOI":"10.4088\/JCP.v67n0712","article-title":"Comparison of quetiapine and risperidone in the treatment of schizophrenia: a randomized, double-blind, flexible-dose, 8-week study","volume":"67","author":"Zhong","year":"2006","journal-title":"J Clin Psychiatry"},{"key":"B18","doi-asserted-by":"publisher","first-page":"34","DOI":"10.4088\/JCP.09m05324gre","article-title":"L-Theanine relieves positive, activation, and anxiety symptoms in patients with Schizophrenia and Schizoaffective Disorder: an 8-week, randomized, double-blind, placebo-controlled, 2-center study","volume":"72","author":"Ritsner","year":"2011","journal-title":"J Clin Psychiatry"},{"key":"B19","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1136\/bmj.323.7304.101","article-title":"Investigating and dealing with publication and other biases in meta-analysis","volume":"323","author":"Sterne","year":"2001","journal-title":"BMJ"},{"key":"B20","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ"},{"key":"B21","doi-asserted-by":"publisher","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"B22","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1007\/s00213-002-1344-3","article-title":"Switching patients to aripiprazole from other antipsychotic agents: a multicenter randomized study","volume":"166","author":"Casey","year":"2003","journal-title":"Psychopharmacology"},{"key":"B23","doi-asserted-by":"publisher","first-page":"61","DOI":"10.9758\/cpn.2013.11.2.60","article-title":"Effects of risperidone and different doses of aripiprazole on cognitive function in patients with stable schizophrenia","volume":"52","author":"Wen","year":"2014","journal-title":"Chin Mod Dr"},{"key":"B24","first-page":"569","article-title":"Dose-effect relationship of aripiprazole in treatment of female patients with hyperprolactinemia caused by risperidone","volume":"25","author":"Chen","year":"2016","journal-title":"Chin J New Drugs"},{"key":"B25","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1586\/14737175.5.3.297","article-title":"Aripiprazole: pharmacology, efficacy, safety and tolerability","volume":"5","author":"Kinghorn","year":"2005","journal-title":"Expert Rev Neurother"},{"key":"B26","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1016\/S0893-133X(02)00304-4","article-title":"Dopamine D 2 and D 3 receptor occupancy in normal humans treated with the antipsychotic drug aripiprazole (OPC 14597): a study using Positron Emission Tomography and [11C]Raclopride","volume":"27","author":"Yokoi","year":"2002","journal-title":"Neuropsychopharmacology"},{"key":"B27","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1007\/s40263-016-0352-5","article-title":"Antipsychotic drug-induced Somnolence: incidence, mechanisms, and management","volume":"30","author":"Fang","year":"2016","journal-title":"CNS Drugs"},{"key":"B28","doi-asserted-by":"publisher","first-page":"659","DOI":"10.2165\/11591710-000000000-00000","article-title":"Antipsychotic pharmacotherapy and orthostatic hypotension","volume":"25","author":"Gugger","year":"2011","journal-title":"CNS Drugs"},{"key":"B29","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1093\/schbul\/sbq042","article-title":"Second-generation antipsychotic drugs and extrapyramidal side effects: a systematic review and meta-analysis of head-to-head comparisons","volume":"38","author":"Rummel-Kluge","year":"2012","journal-title":"Schizophr Bull"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2021.717715\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T05:47:31Z","timestamp":1628660851000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2021.717715\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,11]]},"references-count":29,"alternative-id":["10.3389\/fpsyt.2021.717715"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2021.717715","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,11]]},"article-number":"717715"}}