Dose-reduction algorithm
dose-reductions
For GDR patients, more instructions were delivered regarding the extent and the tempo of dose reduction, warning signal of relapse, timing to call for help if in need to resume rescue dose, and a shared decision-making process during tapering (summarized in online Supplement Table S1).In the beginning, no more than 25% of the baseline antipsychotic dose was reduced at a time. Patients needed to be monitored every 4 weeks (or 1 month) for 3 consecutive sessions once undergoing dose reduction. They would stay at the same dose for another 12 weeks (or 3 months) if maintained stabilized. Thus, the next dose reduction attempt would not be initiated until 24 weeks (or 6 months) of stabilization, defined as no aggravation of symptoms lasting for more than one week during this span. When the patient was eligible to consider next dose reduction, they were empowered to take shared decision-making as they might opt to stay at their current dose for a more extended time if not feeling ready for continuing dose reduction for any reason.The subsequent dose reduction was a reiteration of the previous step, cutting off one-quarter of the current dose, yielding 9/16 (3/4 × 3/4) of baseline dose, rather than cutting off another 1/4 of the baseline dose, as the latter would result in reducing 1/2 (1/4 + 1/4) of the baseline dose after 2 dose-reductions. Importantly, the second formula will 