PM390. Comparison of Fast Versus Slow Strategy in Switching Schizophrenia Patients to Aripiprazole from Other Antipsychotics
Bibliographic record
Abstract
Abstract Objective: This 8-week, open-label, randomized, parallel study aimed to compare strategies differing in the speed of switching schizophrenia patients to aripiprazole from other antipsychotic agents, with dual administration for 2 weeks and then tapering off the current antipsychotic in fast (within 1 week) versus slow (within 4 weeks) strategies. Methods: Patients with a primary DSM-IV diagnosis of schizophrenia or schizoaffective disorder were randomized to either the fast-switching (n=38) or slow-switching (n=41) group. Efficacy assessments at 5 time-points included Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression (CGI) scale. Drug concentrations and cytochrome P450 CYP2D6 and CYP3A4 genotypes were also measured. Results: The fast- and slow-switching groups were comparable in demographical and clinical features at baseline and dropout rate. In the intention-to-treat analysis using mixed-effects models, there were significant within-group decreases over time in the PANSS total scores (p=0.03) and its subscores except for positive subscores, whereas no between-group differences were found. A reduction in body weight (p=0.01) and lower levels of total cholesterol (p=0.03), triglycerides (p=0.03), and prolactin (p=0.01) were noted in both groups, but no increase in extrapyramidal symptoms or prolongation of QTC. The blood concentrations of aripiprazole in all patients were in a therapeutic range at day 56, with CYP2D6*10 polymorphisms being associated with aripiprazole concentrations. However, aripiprazole concentrations (days 14 and 28) were not correlated with change of the PANSS, SAS, AIMS scores. Furthermore, when the outcome was compared based on pre-switch antipsychotic agents (first-generation versus second-generation antipsychotics), there were no significant differences in efficacy or side-effect measures between the two groups. Conclusions: There is no significant difference between fast- and slow-switching strategy in terms of improvements in clinical symptoms and metabolic profile in this 8-week study. This is in contrast to the usual recommendations by experts that slower switching is the preferred approach. Keywords: schizophrenia, aripiprazole, switching strategies, metabolic profile, efficacy, prolactin
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".