Optimal Haloperidol Dosage in First-Episode Psychosis

• Published in: Canadian journal of psychiatry Vol. 44; no. 2; pp. 164 - 167
• Main Authors: Zhang-Wong, J, Zipursky, RB, Beiser, M, Bean, G
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.03.1999; Canadian Psychiatric Association; SAGE PUBLICATIONS, INC
• Subjects: Adult; Analysis of Variance; Antipsychotic Agents - administration & dosage; Antipsychotic Agents - adverse effects; Biological and medical sciences; Dose-Response Relationship, Drug; Drug Administration Schedule; Dyskinesia, Drug-Induced - etiology; Episode of Care; Female; Haloperidol - administration & dosage; Haloperidol - adverse effects; Humans; Male; Medical sciences; Mental disorders; Neuropharmacology; Pharmacology. Drug treatments; Prospective Studies; Psycholeptics: tranquillizer, neuroleptic; Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; Psychosis; Psychotic Disorders - drug therapy; Therapy; Treatment Outcome; haloperidol optimal treatment; haloperidol plasma level; first-episode psychosis; Psychosis; Human; Chemotherapy; Treatment; Neuroleptic; Psychotropic; Schizophrenia; Butyrophenone derivatives; Application method; Haloperidol; Posology
• ISSN: 0706-7437; 1497-0015
• DOI: 10.1177/070674379904400207

Objective: To determine optimal doses of haloperidol for the treatment of a first episode of psychosis. Method: A 4-week prospective controlled clinical trial with “optimal dose” defined as the dose at which either of the following occurs: 1) significant improvement, defined as a 15% or greater decrease in scores on the Positive And Negative Syndrome Scale (PANSS), or 2) the onset of extrapyramidal symptoms. Beginning with 2 mg daily, haloperidol was increased weekly to 5 mg, 10 mg, and finally 20 mg daily until either 1) or 2) occurred. Results: Optimal doses for the 36 subjects were 2 mg daily for 15 subjects, 5 mg daily for 11, 10 mg daily for 7, and 20 mg daily for 3. On average, subjects whose optimal dose was 2 mg daily showed the greatest improvement. Among the 27 subjects evidencing clinical response to treatment, 20 had plasma haloperidol levels below 5 ng/ml. Conclusion: Many people suffering a first psychotic episode respond to haloperidol doses well below levels in common use.