Grant: Project Grant

Background and Importance Continuous antipsychotic treatment represents our current standard of care in the long-term management of schizophrenia. This is a concern because of the significant side effects associated with these drugs. Unfortunately, though, many individuals need to stay on antipsychotic treatment to prevent relapses. Goals/Research Aims Our group has evidence that "extended" antipsychotic dosing represents a possible alternative to continuous antipsychotic exposure. This strategy allows for individuals to take their medications every other day, thereby decreasing their exposure by 50% - a very sizable reduction. This strategy seems to work, but we need to study more individuals to ensure our initial findings are correct. We also need to confirm that this strategy comes with advantages in terms of decreased side effects. Methods/Approach/Expertise The proposed study constitutes a 5-year, randomized controlled trial (i.e. both patients and doctors don't know which treatment an individual is receiving so as not to bias results), comparing continuous vs. extended (i.e. alternate day dosing) antipsychotic treatment over a period of 1 year. Participants will be monitored on a regular basis using a variety of measures to assess clinical and functional outcome, as well as side effects. Expected Outcomes Based on our work to date, we predict comparable clinical efficacy between the 2 study populations. At the same time, we predict benefits in terms of certain clinical measures as well as side effects (e.g. weight gain, risk of diabetes). Further, there will be automatic cost savings in that individuals in the extended dosing receive only 50% of the antipsychotic medication administered to those in the continuous group. This work has the potential to revolutionize maintenance antipsychotic treatment through support of an alternative strategy that decreases antipsychotic exposure by 50%.