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High- v. low-dose quetiapine in schizophrenia: meta-analysis

Nitesh Painuly, Consultant Psychiatrist

Derby City General Hospital, Derbyshire Mental Health Services NHS Trust.

Declaration of interest None.

Correspondence: Correspondence to Nitesh Painuly (nitesh.painuly{at}gmail.com)

Aims and method To study the difference between high- and low-dose quetiapine in acute treatment of schizophrenia. Data available from published double-blind fixed-dose trials were combined and analysed.

Results There was no statistically significant difference between high- (750–800 mg/day) and low-dose (300–400 mg/day) quetiapine in terms of the response rate, change in positive symptoms score and the discontinuation rates either as a result of lack of response or adverse effects.

Clinical implications Combined evidence from fixed-dose trials does not support the prevalent practice of targeting the higher dose of quetiapine for optimal treatment response in schizophrenia.