title: Higher than recommended dosages of antipsychotics in male patients with schizophrenia are associated with increased depression but no major neurocognitive side effects: Results of a cross-sectional pilot naturalistic study.
abstract: The current small pilot naturalistic cross-sectional study assesses whether higher dosages of antipsychotics are related to a satisfactory outcome concerning symptoms of schizophrenia but also to a worse outcome in terms of adverse events and neurocognitive function.
  
  
  
  41 male stabilized hospitalized schizophrenic patients were assessed by PANSS, Calgary Depression Rating Scale, UKU and Simpson-Angus Scale and a battery of neurocognitive tests. Medication and dosage was prescribed according to clinical judgement of the therapist.
  
  
  
  Clinical variables and adverse events did not differ between patients in the recommended vs high dosage groups. Higher dosage correlated with depressive symptoms but there was no correlation with neurocognitive measures except for impaired concentration.
  
  
  
  Results suggest that it is possible to achieve a good clinical response in refractory patients by exceeding recommended antipsychotic dosages at the price of depression and possible mild isolated concentration deficits but not other neurocognitive or extrapyramidal adverse events. Currently clinicians prefer first-generation antipsychotics when high dosages are prescribed, but considering the more favorable adverse effects profile of newer agents, it is important to study higher dosages of these agents and to test whether they should be preferably given when high dosages are necessary.
authors.affiliation: 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, University Hospital AHEPA, 1 Kyriakidi Street, 54636 Thessaloniki, Greece. Electronic address: kfount@med.auth.gr.
authors.forename: Konstantinos N
authors.initials: KN
authors.lastname: Fountoulakis
authors.affiliation: Department of Psychiatry and Psychotherapy, Semmelweis University, Kútvölgyi út 4, 1125 Budapest, Hungary; Department of Pharmacodyamics, Semmelweis University, Nagyvárad tér 4, 1089 Budapest, Hungary; MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Nagyvárad tér 4, 1089 Budapest, Hungary. Electronic address: gonda.xenia@med.semmelweis-univ.hu.
authors.forename: Xenia
authors.initials: X
authors.lastname: Gonda
authors.affiliation: 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, University Hospital AHEPA, 1 Kyriakidi Street, 54636 Thessaloniki, Greece. Electronic address: siamel@msn.com.
authors.forename: Melina
authors.initials: M
authors.lastname: Siamouli
authors.affiliation: 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, University Hospital AHEPA, 1 Kyriakidi Street, 54636 Thessaloniki, Greece. Electronic address: katerinamoutou@yahoo.fr.
authors.forename: Katerina
authors.initials: K
authors.lastname: Moutou
authors.affiliation: 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, University Hospital AHEPA, 1 Kyriakidi Street, 54636 Thessaloniki, Greece. Electronic address: zizelnitsa@gmail.com.
authors.forename: Zoe
authors.initials: Z
authors.lastname: Nitsa
authors.affiliation: National University of Ireland, Galway, University Road, Galway, Ireland. Electronic address: belucg@iol.ie.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Leonard
authors.affiliation: Universitätsklinik für Psychiatrie und Psychotherapie Medizinische Universität Wien, Währinger Gürtel 18-20, 1090 Vienna, Austria. Electronic address: biol-psychiatry@meduniwien.ac.at.
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kasper
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003863:Depression / Q000139:chemically induced*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012559:Schizophrenia / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
keywords: Antipsychotics; Depression; High dosage; Neurocognitive side effects