Cited by 408Schizophrenia research and treatmentNeurotransmitter Receptor Influence on BehaviorTreatment of Major Depression

Delayed-Onset Hypothesis of Antipsychotic Action: A Hypothesis Tested and Rejected

Agid, Ofer, Kapur, Shitij, Arenovich, Tamara, Zipursky, Robert B.·2003·Archives of General Psychiatry

Abstract

Context To understand the mechanism of action of antipsychotic drugs, it is critical to recognize the time course over which these medications take effect. Current models of antipsychotic action presume a "delayed onset" of action. Objective To test the delayed-onset hypothesis of antipsychotic action via a meta-analytic study. Data sources and study selection Double-masked studies that reported results from active or placebo-controlled trials of antipsychotic response during the first 4 weeks of treatment were selected. These studies were identified by searching MEDLINE, 1996 to 2001; the Cumulative Index to Nursing and Allied Health, 1982 to 2001; EMBASE, 1980 to 2001; the ACP Journal Club; the Cochrane Database of Systematic Reviews; and the Database of Abstracts of Reviews of Effectiveness. Leads from these sources were followed up by manual searches. Data synthesis Forty-two published studies, including 7450 patients and 119 independent response vs time curves, were identified. Reductions in total scores on the Brief Psychiatric Rating Scale and the Positive and Negative Syndrome Scale were 13.8% during week 1, 8.1% during week 2, 4.2% during week 3, and 4.7% during week 4. This pattern of "early-onset" improvement was present even after the estimated effect of placebo treatment was removed and when results were restricted to the psychotic subscales of the scales. Conclusions This analysis rejects the commonly held hypothesis that antipsychotic response is delayed. Rathe…

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Crossref · 10.1001/archpsyc.60.12.1228

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  • Factors contributing to rapid improvement may include medication effects (e.g., antidepressant, antipsychotic agents), removal of alcohol and substances, and psychotherapy gains.

    “Factors contributing to rapid improvement may include medication effects (e.g., antidepressant, antipsychotic agents) (Agid et al., 2003; Posternak and Zimmerman, 2005), removal of alcohol and substances, and psychotherapy gains (Stiles et al., 2003).”

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Authors
Agid, O., Kapur, S., Arenovich, T., & Zipursky, R. B.
Affiliations
Centre for Addiction and Mental Health (CA)
Venue
Archives of General Psychiatry
Published
2003-12-01
Volume
60
Issue
12
Pages
1228
ISSN
0003-990X (ISSN-L)
OpenAlex
W2000636120
Cited by
408
References
86
Citations by year
2026: 5 · 2025: 10 · 2024: 9 · 2023: 5 · 2022: 14 · 2021: 8 · 2020: 14 · 2019: 10 · 2018: 21 · 2017: 16 · 2016: 16 · 2015: 20 · 2014: 24 · 2013: 26 · 2012: 31
FWCI
8.77
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of General Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
antipsychotic drugs, mechanism of action, schizophrenia, Brief Psychiatric Rating Scale, PANSS, placebo response
MeSH terms
Adolescent, Adult, Aged, Double-Blind Method, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Psychotic Disorders, Time Factors, Antipsychotic Agents, Treatment Outcome, Controlled Clinical Trials as Topic

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