The chance and the extent of dose reduction
REMISSION, SYNDROME
The trajectories and extent of actual dose tapering of the GDR group varied widely (view example illustrations in online Supplement Fig. S3). Among them, by the end of 2-year follow-up, 18 patients (35.3%) completed 4 consecutive dose tapering steps as designated by our proposed algorithm, on average reduced to 40% of their baseline dose; 20 patients (39.2%) took 1 to 3 steps of dose tapering during the course and were able to stay at reduced dose levels (50% to 80% of baseline); 7 patients (13.7%) eventually needed to resume their baseline dose in precaution as to prevent from full-blown relapse; 6 patients (11.8%) experienced relapse, including 2 of them being hospitalized.In total, 74.5% of GDR patients maintained in remission with no relapse under a dose lower than their baseline levels, on average 39% of baseline dose reduced. For comparison, the MT1 patients who were interested in taking dose reduction but designated to the maintenance group also on average successfully reduced 11% of their baseline dose by the end of 2 years on their own accord; while the MT2 patients who preferred to take a conservative stance stayed with their baseline dose (Comparison of differences in clinical scores at baseline and by the end of completing 2 years follow-up among 3 groupsAbbreviations: 2Y, the end of 2-year follow-up; BL, baseline; CGI-S, clinical global impression-severity; CPZE chlorpromazine equivalent dose; EQ-5D-VAS, EuroQoL-5D visual analogue scale; GDR, patients randomized to guided dose reduction group; MSQ, medication satisfaction questionnaire; MT1, patients randomized to maintenance group; MT2, patients volunteered to be the naturalistic observational group; PANSS, positive and negative syndrome scale; PSP, personal and social performance.