Publication Name	World Journal of Psychiatry
Manuscript ID	113548
Country	China

Category	Psychiatry
Manuscript Type	Letter to the Editor
Article Title	Initial lurasidone dosing in acute schizophrenia: Pragmatic and trajectory-aware clinical implications
Manuscript Source	Invited Manuscript
All Author List	Yang Liu and Tao Liu
Funding Agency and Grant Number
Corresponding Author	Tao Liu, Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China. liu_t2019@163.com
Key Words	Lurasidone; Schizophrenia; Antipsychotic agents; Treatment outcome; Akathisia; Body weight
Core Tip	Choosing a starting dose may influence the early clinical trajectory in acute schizophrenia. In a pragmatic randomized study, 80 mg/day for the first week led to more rapid improvement in Positive and Negative Syndrome Scale positive symptoms than 40 mg/day, with similar discontinuation for adverse events and no short-term metabolic penalty. Clinicians may prioritize speed with 80 mg/day when tolerated, or start at 40 mg/day when akathisia risk is a concern, coupled with a day-7 review for escalation. Open-label design and dose convergence temper causal claims, but initial dose selection may shape the early trajectory.
Citation	Liu Y, Liu T. Initial lurasidone dosing in acute schizophrenia: Pragmatic and trajectory-aware clinical implications. World J Psychiatry 2025; In press

Received	2025-08-27 23:06
Peer-Review Started	2025-08-27 23:06
To Make the First Decision
Return for Revision	2025-09-04 06:56
Revised	2025-09-13 13:55
Second Decision	2025-11-06 02:48
Accepted by Journal Editor-in-Chief
Accepted by Executive Editor-in-Chief	2025-11-06 06:31
Articles in Press	2025-11-06 06:31
Publication Fee Transferred
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2220-3206 (online)
Open Access	This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Copyright	© The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Permissions	For details, please visit: http://www.wjgnet.com/bpg/gerinfo/207
Publisher	Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Website	http://www.wjgnet.com