Evidence mapPaperPMID 40840435Full record

ArticleSchizophrenia bulletin2026

The Effects of Antipsychotic Dose Reduction on Movement Disorders and Cardiometabolic Indices in Patients Remitted from a First Episode of Psychosis.

Yinzhao Liu, Iris E Sommer, Marieke J H Begemann, Shiral S Gangadin, Benjamin I Perry, Toon A W Scheurink, Nico J M van Beveren, HAMLETT and OPHELIA Consortium, Pieter Roberto Bakker, Sanne Koops

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In one paragraph

Article in Schizophrenia bulletin, 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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0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Yinzhao LiuDepartment of Biomedical Sciences, Cognitive Neuroscience Center, University Medical Center Groningen (UMCG), University of Groningen, Groningen 9713 GZ, The Netherlands.ORCID 0000-0002-4156-4852
Iris E SommerDepartment of Biomedical Sciences, Cognitive Neuroscience Center, University Medical Center Groningen (UMCG), University of Groningen, Groningen 9713 GZ, The Netherlands.
Marieke J H BegemannDepartment of Biomedical Sciences, Cognitive Neuroscience Center, University Medical Center Groningen (UMCG), University of Groningen, Groningen 9713 GZ, The Netherlands.ORCID 0000-0001-6448-2799
Shiral S GangadinDepartment of Biomedical Sciences, Cognitive Neuroscience Center, University Medical Center Groningen (UMCG), University of Groningen, Groningen 9713 GZ, The Netherlands.ORCID 0000-0002-0084-8226
Benjamin I PerryInstitute for Mental Health, University of Birmingham, Birmingham B15 2TT, United Kingdom.
Toon A W ScheurinkDepartment of Biomedical Sciences, Cognitive Neuroscience Center, University Medical Center Groningen (UMCG), University of Groningen, Groningen 9713 GZ, The Netherlands.
Nico J M van BeverenDepartment of Biomedical Sciences, Cognitive Neuroscience Center, University Medical Center Groningen (UMCG), University of Groningen, Groningen 9713 GZ, The Netherlands.
HAMLETT and OPHELIA Consortium
Pieter Roberto BakkerDepartment of Biomedical Sciences, Cognitive Neuroscience Center, University Medical Center Groningen (UMCG), University of Groningen, Groningen 9713 GZ, The Netherlands.
Sanne KoopsDepartment of Biomedical Sciences, Cognitive Neuroscience Center, University Medical Center Groningen (UMCG), University of Groningen, Groningen 9713 GZ, The Netherlands.

Funding

Dutch Medical Science Foundation ZonMW 348041003Dutch Medical Science Foundation ZonMW 636340001
6 · The paper itself

Abstract

background and hypothesisThe extent to which tapering antipsychotic (AP) attenuates AP-related movement disorders and cardiometabolic dysfunction remains unclear. We aim to investigate the long-term effects of AP-dose reduction on these adverse effects in patients remitted from a first episode of psychosis (FEP). STUDY

methodsWe included 293 FEP participants from the HAMLETT trial. Movement disorders were assessed using the St. Hans Rating Scale (SHRS) and Barnes Akathisia Rating Scale. Cardiometabolic indices included body mass index (BMI), waist circumference, blood pressure (BP), glucose, triglycerides, and cholesterol. Linear mixed-effects models assessed longitudinal relationships between AP-dose reduction, movement disorders and cardiometabolic indices. STUDY

resultsOver an average 29-month follow-up (SD = 19), a 1 mg olanzapine equivalent dose reduction from baseline was associated with a 0.013-point decrease in Parkinsonism (95% CI, -0.019, -0.006), a potential 0.003-point decrease in tardive dyskinesia (95% CI, -0.006, -0.000) on SHRS (range 0-6), and decreases of 0.037 (0.15%) kg/m2 in BMI (95% CI, -0.059, -0.015), 0.153 (0.17%) cm in waist circumference (95% CI, -0.265, -0.037), 0.023 (0.47%) mmol/L in total cholesterol (95% CI, -0.039, -0.007), 0.018 (0.60%) mmol/L in low-density lipoprotein cholesterol (95% CI, -0.032, -0.003), and 0.021 (0.58%) mmol/L in nonhigh-density lipoprotein cholesterol (95% CI, -0.037, -0.005). We found no evidence for an association with tardive dystonia, akathisia, BP, glucose, or triglycerides.

conclusionsAP-dose reduction modestly benefits AP-related Parkinsonism, weight gain, cholesterol levels and potentially tardive dyskinesia in patients after FEP over time. These benefits should be carefully weighed against the risks of relapse and suicide.

Indexed as

Antipsychotic AgentsDrug TaperingMovement DisordersOlanzapineOutcome Assessment, Health CarePsychotic DisordersSchizophreniaTardive DyskinesiaAdolescentAdultCholesterolFemaleFollow-Up StudiesHumansMaleYoung AdultAntipsychotic AgentsCholesterolOlanzapineantipsychotic agentsdose dependencyextrapyramidal side effectsmetabolic disturbances

Identifiers

PMID40840435
PMCPMC13391666

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.