ArticleWorld journal of psychiatry2026
Initial lurasidone dosing in acute schizophrenia: Pragmatic and trajectory-aware clinical implications.
Article in World journal of psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
Selecting the initial antipsychotic dose is a high-impact decision in acute schizophrenia. A randomized study found that starting lurasidone at 80 mg/day for 1 week (then flexible titration) produced earlier reductions in Positive and Negative Syndrome Scale positive symptoms than 40 mg/day, without higher discontinuations for adverse events or a metabolic penalty over 6 weeks. These data support an individualized approach: Start at 80 mg/day when rapid control of positive symptoms or agitation is needed and tolerance permits; start at 40 mg/day when akathisia risk or patient preference argues for caution, with a planned day-7 review for up-titration. The open-label design, dose convergence after week 1, and the lack of stratified randomization limit attribution of longer-term advantages to starting dose. Even so, the trial reframes initial dose as a modifiable lever for the early course rather than a one-size-fits-all rule and warrants confirmation in larger, double-blind randomized trials.
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