Keio University · Medicine
Professor Hiroyoshi Takeuchi's research lab focuses on optimizing antipsychotic treatment strategies in schizophrenia, with a strong emphasis on pharmacological efficacy, tolerability, and long-term outcomes. Key research directions include the evaluation of antipsychotic polypharmacy, particularly its impact on QTc prolongation; the identification of minimum effective doses in acute schizophrenia; and the comparative effectiveness of antipsychotic discontinuation strategies. The lab also investigates adherence to clozapine and the use of symptom trajectory analysis via clinical rating scales to inform maintenance treatment decisions.
Figures are computed from collected data and may differ slightly.
Currently available evidence fails to confirm that antipsychotic polypharmacy worsens QTc prolongation in general, although the evidence is scarce and inconsistent. Clinicians are advised to remain conservative in resorting to antipsychotic polypharmacy, as a combination of some QTc-prolongation liable antipsychotics may further prolong QTc interval, and efficacy supporting the clinical benefits of antipsychotic polypharmacy is equivocal, at best.
<b>Visual Summary (In Japanese)</b>.
<b>Background</b>As definitions of relapse differ substantially between studies, in investigations involving data aggregation, total scores on clinical rating scales provide a more generalisable outcome.<b>Aims</b>To compare total symptom trajectories for antipsychotic versus placebo treatment over a 1-year period of maintenance treatment in schizophrenia.<b>Method</b>Randomised controlled trials with antipsychotic and placebo treatment arms in patients with stable schizophrenia that reported Po
These findings indicate that either immediate or gradual discontinuation of the current antipsychotic medication represents a viable treatment option. Clinicians are advised to choose an antipsychotic switching strategy according to individual patient needs. This said, immediate discontinuation may be advantageous both for simplicity and because a stalled cross-titration process in antipsychotic switching could end up in antipsychotic polypharmacy.
Little is known regarding optimal antipsychotic doses in the acute phase of schizophrenia. The aim of the present study was to employ the concept of minimum effective dose (MED) in examining efficacy and tolerability within this population. MED was identified for each antipsychotic through a previous systematic review. We then identified double-blind placebo-controlled randomized trials that involved fixed-dose antipsychotic monotherapy in acute schizophrenia and compared the identified MED vs h
Findings suggest that in patients with schizophrenia clozapine adherence is at least comparable, if not slightly better, compared with other antipsychotics.
Although recent treatment guidelines for schizophrenia recommend that the prior antipsychotic agent should remain stable for at least 2 weeks when aripiprazole is introduced, there is no trial-based evidence to support this strategy. This study was designed to compare this strategy with another conventional one in patients with schizophrenia. We conducted a randomized, 14-week, open-label trial to compare the following 2 switching strategies: (1) add-on of aripiprazole on a current regimen, wait
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