S110. LONG-ACTING ARIPIPRAZOLE IN FIRST-EPISODE PSYCHOSIS: DOES ONE SIZE FIT ALL?
Bibliographic record
Abstract
Recommendation on long-acting injectable (LAI) aripiprazole dosage based on phase II and phase III are that a 400mg dosage would be appropriate in 90% of patients and 300mg in 10%. Since these trials were performed in patients aged around 40, it is not known if they apply to first-episode psychosis (FEP). We systematically reviewed extensive medical charts of all 61 patients from our FEP program who have been exposed to LAI Aripiprazole (average exposure: 15 months) and followed intensively by an inter-disciplinary team. Two trained psychiatry residents independently performed monthly retrospective ratings of efficacy (CGI-S) and tolerability (CGI-CB side effects subscale) and disagreements were reviewed to reach consensus, and dosage for each injection as interval between them were recorded. All patients were treated with oral Aripiprazole prior to their first injection and the dosage that provided both efficacy and tolerability was considered in determining the target LAI dosage based on pharmacokinetics data. Depending on the oral dose used, the first injection was either 400 or 300mg; the LAI dosage targeted at equilibrium was approximately 20 mg for 1 mg po, and was adjusted based on response and tolerability. 47.5% of patients were stabilized (CGI-S≤3; CGI-CB subscale ≤2 for ≥6 months) at dosages <300mg and 14.8% at dosages ≤200mg. 8/49 patients who received ≤300 mg at some stage required lower dosage due to side effects. These preliminary results of our ongoing study suggest that it may be appropriate and/or needed to use LAI Aripiprazole dosage below 300mg in a significant proportion of FEP patients; hence, close monitoring of severity and tolerability may be required to “fine tune” LAI Aripiprazole dosage.
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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 | 0.005 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.005 | 0.002 |
| Insufficient payload (model declined to judge) | 0.020 | 0.010 |
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".