Haloperidol in Acute Schizophrenic Inpatients A Double-blind Comparison of Two Dosage Regimens

Modestin, Jiří; G, Toffler; M, Pia; Greub, E

doi:10.1055/s-2007-1019484

Cited by 11 publications

(3 citation statements)

References 7 publications

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“…The changes of dosage regimens cannot be explained by scientific reasoning as numerous studies have shown that higher dosages are not superior to lower dosages (Hebenstreit et al, 1980;Modestin et al, 1983). Perhaps the psychiatrists of the early seventies were not satisfied with the outcome of neuroleptic treatment and wanted to achieve more control of psychotic symptoms by administering higher dosages.…”

Section: Discussionmentioning

confidence: 99%

Neuroleptics in the Treatment of Schizophrenia: Have there been Changes in the Dosage Regimen?

König¹,

Kunow²,

Kniehl³

et al. 1986

Pharmacopsychiatry

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Section: Discussionmentioning

confidence: 99%

Neuroleptics in the Treatment of Schizophrenia: Have there been Changes in the Dosage Regimen?

König¹,

Kunow²,

Kniehl³

et al. 1986

Pharmacopsychiatry

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“…Some studies of acute schizophrenic patients have supported the concept of a serum levelresponse relationship (Mendlewicz et al, 1981), while others have failed to find such a relationship (Ericksen, Hurt and Chang, 1978;Silverstone et al, 1984). High dose HPL treatment does not appear to offer advantages to the majority of acutely ill schizophrenic patients (Ericksen, Hurt and Chang, 1978;Donlon et al, 1980;Modestin et al, 1983) and may cause i unacceptably high levels of unwanted side-effects (Bollini et al, 1984). A curvilinear relationship has been suggested by several authors and a range of 'therapeutic windows' proposed: [8][9][10][11][12][13][14][15][16][17][18] ng/ml (Magliozzi et al, 1981) 5-15 ng/ml (Smith et al, 1982;Extein, Pottash and Gold, 1983) 4.2-11.0 n /ml (Mavroidis et al, 1983) 11-126 ng ml (Kucharski et al, 1984) 4-26 ng/ml (Potkin et al, 1985) 6.5-16.5 ng/ml (Smith et al, 1985) Hollister and Kim (1982) proposed a therapeutic range at a higher level (20-50 ng/ml) for 'treatment-resistant' cases.…”

Section: Introductionmentioning

confidence: 92%

Serum haloperidol levels and clinical response in chronic, treatment-resistant schizophrenic patients

Browne¹,

Cooper²,

Wilson

et al. 1988

J Psychopharmacol

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Eleven chronic treatment-resistant schizophrenic in-patients were treated with haloperidol (HPL) or placebo with a fixed ascending dose schedule for 20 weeks. Seven patients relapsed and were withdrawn and five of these re-entered, single-blind, on known active treatment. Two weekly clinical ratings and weekly serum HPL levels were carried out throughout the study. More patients on placebo dropped out and at an earlier stage than those on active treatment but the difference was not statistically significant. Despite wide individual variations in both serum HPL levels and clinical response, these were positively correlated. HPL appeared to be of more value in the prevention of relapse than in symptom reduction. Overall, the clinical response was poor and a 'therapeutic window' could not be demonstrated either for the group as a whole or in any individual patient. There was no additional therapeutic benefit in exceeding serum HPL levels of 20 ng/ml in any of our patients. Since this serum level was achieved by daily doses of 10-40 mg HPL and the relationship between dose and serum level is linear, the use of serum HPL estimations is not likely to be of value in the routine clinical management of treatment-resistant patients.

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“…Although high doses are sometimes necessary for severely psychotic patients, doses of 300 mg/day are sufficient for most schizophrenic patients and are associated with fewer side effects and greater compliance (91). Frequent intramuscular injections of high potency neuroleptics (&dquo;rapid neuroleptization&dquo;) are no more effective than standard doses in acute schizophrenia and are more likely to cause extrapyramidal reactions (92)(93)(94).…”

Section: Drug Treatment Of Psychosis and Agitationmentioning

confidence: 99%

Review Article: Psychopharmacologic Treatment in Neurological Practice

Dubovsky

Ringel

1987

Neurorehabilitation and Neural Repair

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Colorado 80262.Numerous medications are currently available to treat behavioral disturbances that are commonly encountered in neurological practice. This paper reviews psychopharmacotherapy of depression, mania, anxiety, agitation, and psychosis. The effects of commonly used psychotropic agents in neurological patients, particularly those who are elderly, are emphasized. DepressionDiagnosis At any given time, 4-6% of men and twice as many woman are clinically depressed; the lifetime risk of depression is approximately 12% for men and 25% for women (1). Depression is typically manifested by a disturbance in mood (depressed, irritable, and/or anxious), thinking (helplessness, hopelessness, negativism, suicidal thoughts, self-blame, lowered self-esteem, psychomotor slowing), and vegetative function (appetite and weight change, sleep disturbance, diurnal and seasonal variation in mood). Not infrequently, neurological illnesses and/or the medications used to treat them cause depression. For example, 50-70% of patients with left hemisphere strokes develop clinical depression (2-5). Anticonvulsants, tranquilizers, and corticosteroids are common causes of depression in neurological patients (6,7). Right hemispheral dysfunction, diffuse brain disease, and some personality disorders might interfere with the ability to express emotion directly so that depressed mood is &dquo;masked&dquo; by other complaints.Most common among these are disturbances of social functioning (e.g., marital problems, frequent job changes, personality deterioration, chronic insomnia), behavior (e.g., disheveled appearance, hostility, substance abuse, catatonia, agitation, failure to recover as expected from neurological illness), thinking, (e.g., negativism, noncompliance, pseudodementia, physical complaints, expression of a wish to die), or affect (e.g., inappropriate or labile affect) (3,7,8).

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Haloperidol in Acute Schizophrenic Inpatients A Double-blind Comparison of Two Dosage Regimens

Cited by 11 publications

References 7 publications

Neuroleptics in the Treatment of Schizophrenia: Have there been Changes in the Dosage Regimen?

Neuroleptics in the Treatment of Schizophrenia: Have there been Changes in the Dosage Regimen?

Serum haloperidol levels and clinical response in chronic, treatment-resistant schizophrenic patients

Review Article: Psychopharmacologic Treatment in Neurological Practice

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