When is an antipsychotic dosage decrease appropriate in older patients? The question is especially important because patients with late-life schizophrenia (LLS) are much more susceptible to antipsychotic adverse effects. An article appearing in JAMA Psychiatry offers an answer, suggesting that antipsychotic dose reduction is feasible in patients with stable LLS, decreasing adverse effects and improving illness severity measures. The study focused on 35 outpatients, all age 50 years or older, with clinically stable LLS and who were receiving olanzapine or risperidone monotherapy at the same dose for 6 to 12 months. Participants underwent a gradual dose reduction of up to 40%, with average dopamine D2/3R occupancies dropping from 70% to 64% after the dosage reduction.

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