Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-04T21:57:26.450Z Has data issue: false hasContentIssue false

Dosage of Haloperidol for Mania

Published online by Cambridge University Press:  02 January 2018

Arthur Rifkin*
Affiliation:
Mount Sinai School of Medicine, New York, and Department of Psychiatry, Elmhurst Hospital Center Affiliation, of the Mount Sinai Medical Center, Elmhurst, NY
Seshagiri Doddi
Affiliation:
Mount Sinai School of Medicine, and Department of Psychiatry, Elmhurst Hospital Center Affiliation, of the Mount Sinai Medical Center
Basawaraj Karajgi
Affiliation:
Mount Sinai School of Medicine, and Department of Psychiatry, Elmhurst Hospital Center Affiliation, of the Mount Sinai Medical Center
Michael Borenstein
Affiliation:
Department of Biostatistics, Hillside Hospital, Long Island Jewish Medical Center, Glen Oaks, NY
Ralph Munne
Affiliation:
Department of Psychiatry, Elmhurst Hospital Center Affiliation, of the Mount Sinai Medical Center
*
Prof. A. Rifkin, Attending Psychiatrist, Hillside Hospital, Long Island Jewish Medical Center, Glen Oaks, NY 11004, USA

Extract

Background

We compared three doses of a neuroleptic as a treatment for mania.

Method

Forty-seven newly admitted in-patients with mania were randomised to receive 10, 30, or 80 mg a day of oral haloperidol, under double-blind conditions for up to six weeks. All subjects received prophylactic benztropine.

Results

Repeated-measures analysis of variance and survival analysis showed no difference in outcome by the different doses. Excluding drop-outs (38%), most of whom left the study during the first two weeks, 72% of the subjects responded. Side-effects were minimal; there were no differences among the three doses. Non-responders received more adjunctive lorazepam than responders.

Conclusions

The limited data suggest that more than 10 mg a day of haloperidol offers no advantage in mania.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1994 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: American Psychiatric Association.Google Scholar
Baker, L. A., Cheng, L. Y. & Amara, I. B. (1983) The withdrawal of benztropine mesylate in chronic schizophrenic patients. British Journal of Psychiatry, 143, 584590.CrossRefGoogle ScholarPubMed
Chou, J. C.-Y. (1991) Recent advances in treatment of acute mania. Journal of Clinical Psychopharmacology, 11, 321.Google Scholar
Donlon, P. T., Meadow, A., Tupin, J. P., et al (1978) High vs. standard dosage fluphenazine HCl in acute schizophrenia. Journal of Clinical Psychiatry, 39, 800804.Google ScholarPubMed
Donlon, P. T., Hopkin, J. T. & Tupin, J. P. (1980) Haloperidol for acute schizophrenic patients: an evaluation of three oral regimens. Archives of General Psychiatry, 37, 691695.CrossRefGoogle ScholarPubMed
Endicott, J., Spitzer, R. L. & Fleiss, J. (1976) The Global Assessment Scale: a procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry, 33, 766771.Google Scholar
Ericksen, S., Hurst, S. & Chang, S. (1978) Haloperidol dose, plasma levels, and clinical response: a double-blind study. Psychopharmacology Bulletin, 14, 1516.Google ScholarPubMed
Escober, J. I., Barron, A. & Kiriakos, R. (1983) Serum levels of fluphenazine: effect of dosage and route of administration, and relation to side effects and clinical response. Psychopharmacology Bulletin, 19, 131134.Google Scholar
Garfinkel, P. E., Stancer, H. C. & Persad, E. (1980) A comparison of haloperidol, lithium carbonate and their combination in the treatment of mania. Journal of Affectve Disorders, 2, 279288.Google Scholar
Guy, W. (1976) ECDEU Assessment Manual for Psychopharmacology. Washington DC: Department of Health, Education and Welfare Publications (ADM).Google Scholar
Johnson, G., Gershon, S. & Hekimian, L. J. (1968) Controlled evaluation of lithium and chlorpromazine in the treatment of manic states: an interim report. Comprehensive Psychiatry, 9, 563.CrossRefGoogle ScholarPubMed
Johnson, G., Gershon, S., & Burdock, E. I. (1971) Comparative effects of lithium and chlorpromazine in the treatment of acute manic states. British Journal of Psychiatry, 119, 267.CrossRefGoogle ScholarPubMed
Johnstone, E. C., Crow, T. J., Ferrier, I. N., et al (1983) Adverse effects of anticholinergic medication on positive schizophrenic symptoms. Psychological Medicine, 13, 513527.CrossRefGoogle ScholarPubMed
Levinson, D. F., Simpson, G. M., Singh, H., et al (1990) Fluphenazine dose, clinical response, and extrapyramidal symptoms during acute treatment. Arch Gen Psychiatry, 47, 761768.Google Scholar
Manos, N., Gkiouzepas, J. (1981) Discontinuing anti-parkinson medication in chronic schizophrenics. At what cost to the patient? Acta Psychiatrica Scandinavica, 63, 2832.CrossRefGoogle Scholar
Manos, N., Gkiouzepas, J. & Logothetis, J. (1981) The need for continuous use of anti-parkinsonian medication within chronic schizophrenic patients receiving long-term neuroleptic therapy. American Journal of Psychiatry, 138, 184188.Google Scholar
McEvoy, J. P., Hogarty, G. E. & Steingard, S. (1991) Optimal dose of neuroleptic in acute schizophrenia: a controlled study of the neuroleptic threshold and higher haloperidol dose. Archives of General Psychiatry, 48, 739745.CrossRefGoogle ScholarPubMed
Neborsky, R., Janowsky, D., Munson, E., et al (1981) Rapid treatment of acute psychiatric symptoms with high and low dose haloperidol. Archives of General Psychiatry, 38, 195199.Google Scholar
Post, R. M., Jimerson, D. C., Bunney, W. E., et al (1980) Dopamine and mania: behavioral and biochemical effects of the dopamine receptor blocker pimozide. Psychopharmacology, 67, 297305.Google Scholar
Prien, R. F., Caffey, E. M. Jr & Klett, C. J. (1972) A comparison of lithium carbonate and chlorpromazine in the treatment of acute mania. Archives of General Psychiatry, 26, 146153.Google Scholar
Putten, T. Van, Marder, S. R. & Mintz, J. (1990) A controlled dose comparison of haloperidol in newly admitted schizophrenic patients. Archives of General Psychiatry, 47, 754758.CrossRefGoogle ScholarPubMed
Shopsin, B., Gershon, S. & Thompson, H. (1975) Psychoactive drugs in mania. Archives of General Psychiatry, 32, 3442.Google Scholar
Simpson, G. M. & Anous, J. (1970) A rating scale for extrapyramidal side-effects. Acta Psychiatrica Scandinavica, 212 (suppl.), 1119.Google Scholar
Singh, M. M. & Kay, S. R. (1975) Therapeutic reversal with benztropine in schizophrenics. Journal of Nervous and Mental Disease, 160, 258266.CrossRefGoogle ScholarPubMed
Manos, N., Gkiouzepas, J. (1979) Therapeutic antagonism between anticholinergic anti-parkinsonian agents with neuroleptics in schizophrenia: implications for a neuropharmacological model. Neuropsychobiology, 5, 7486.Google Scholar
Spitzer, R. L. & Endicott, J. (1978) Schedule for Affective Disorders and Schizophrenia (3rd edn). New York: Biometrics Research Division, New York State Psychiatric Institute.Google Scholar
Wijsenbeeck, H., Steiner, M. & Goldberg, S. C. (1974) Trifluoperazine: a comparison between regular and high doses. Psychopharmacologia, 36, 147150.CrossRefGoogle Scholar
Submit a response

eLetters

No eLetters have been published for this article.