Preparation for Child Psych PRITE and Boards
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Dose Equivalence and Effect Size Meta-analysis

A useful meta-analysis was published in 2020 evaluating studies of acute symptoms of schizophrenia (1).

  • A number of antipsychotics demonstrated 95% response (ED95) (near maximum reduction in symptoms) well below their maximum licensed dose. For example, risperidone, which is licensed to be used at 16mg/day, showed ED95 at 6.26 mg/day and aripiprazole at 11.5 mg/day, while haloperidol's ED95 was only 6.3mg/day.
  • At their respective ED95 dose, risperidone had an effect size (SMD) of 0.6 and aripiprazole 0.42.
  • Conversely there was no clear plateau in response for clozapine at 600 mg (SMD >1) and olanzapine at 20mg (SMD 0.5), suggesting that higher doses may produce further response

[1] Stefan Leucht, M.D. Dose-Response Meta-Analysis of Antipsychotic Drugs for Acute Schizophrenia Am J Psychiatry 2020; 177:342–353