Xing HY, Yan J. Critical commentary on initial lurasidone dosing strategies in acute schizophrenia. World J Psychiatry 2026; 16(3): 114882 [DOI: 10.5498/wjp.v16.i3.114882]
Corresponding Author of This Article
Juan Yan, MD, Professor, The Affiliated Mental Health Center and Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310013, Zhejiang Province, China. 294162939@qq.com
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Psychiatry
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Letter to the Editor
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Mar 19, 2026 (publication date) through Feb 27, 2026
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Publication Name
World Journal of Psychiatry
ISSN
2220-3206
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Xing HY, Yan J. Critical commentary on initial lurasidone dosing strategies in acute schizophrenia. World J Psychiatry 2026; 16(3): 114882 [DOI: 10.5498/wjp.v16.i3.114882]
World J Psychiatry. Mar 19, 2026; 16(3): 114882 Published online Mar 19, 2026. doi: 10.5498/wjp.v16.i3.114882
Critical commentary on initial lurasidone dosing strategies in acute schizophrenia
Hao-Yu Xing, Juan Yan
Hao-Yu Xing, Department of Medical Engineering, The Affiliated Mental Health Center and Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310013, Zhejiang Province, China
Juan Yan, Quality Control Office, The Affiliated Mental Health Center and Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310013, Zhejiang Province, China
Author contributions: Xing HY wrote the original draft; Yan J contributed to the conceptualization, writing, reviewing, and editing; Xing HY and Yan J participated in drafting the manuscript. All authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Juan Yan, MD, Professor, The Affiliated Mental Health Center and Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310013, Zhejiang Province, China. 294162939@qq.com
Received: October 9, 2025 Revised: November 1, 2025 Accepted: December 23, 2025 Published online: March 19, 2026 Processing time: 146 Days and 0.4 Hours
Abstract
This letter critically examines the study by Liu et al comparing 40 mg/day and 80 mg/day initial lurasidone doses in Chinese patients with acute schizophrenia. The analysis focuses on the study’s pragmatic design, safety outcomes, and early efficacy trends, including the paradoxical observation of greater weight gain at lower doses. By contextualizing the study’s findings within existing antipsychotic dosing literature, this commentary discusses implications for personalized treatment, while addressing methodological limitations. The letter aims to stimulate further research on optimal dosing strategies in real-world settings.
Core Tip: Liu et al provide evidence challenging the conventional “start low, go slow” approach for lurasidone in acute schizophrenia. Their trial suggests that initiating treatment at 80 mg/day is as safe as 40 mg/day, and may offer faster symptom control. This commentary discusses these findings in the context of prior dosing studies, emphasizing the need for tailored strategies while noting methodological constraints.
