The Antipsychotic Load (AP_Load2026): a normalised prescribed-dose index for schizophrenia research

In schizophrenia patients, the Antipsychotic Load (AP_Load2026) clozapine reference individualized for sex and cigarettes per day tracks plasma clozapine better, with marginal R² 0.249 vs 0.166.

• Why it matters: Existing single-number summaries of antipsychotic dose disagree, especially for clozapine where dose–concentration varies with sex and smoking, limiting comparability across studies.
• What they did: AP_Load2026 expresses each daily dose as a percentage of a reference dose, sums uncapped, and tests the clozapine term against plasma clozapine using log-log mixed-effects models across 1316 assessments in 255 patients.
• The result: The individualized smoking-corrected scheme fits best (0.249 vs 0.231), and for other antipsychotics %BNFmax is least consistent with external criteria, supporting AP_Load2026 for clozapine-enriched cohorts.

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