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High-Dose Neuroleptics: Uncontrolled Clinical Practice Confirms Controlled Clinical Trials

Published online by Cambridge University Press:  29 January 2018

Paola Bollini*
Affiliation:
Laboratory of Clinical Pharmacology, Istituto di Ricerche Farmacologiche “Mario Negri”, Via Eritrea, 62, 20157–Milan, Italy
Amato Andreani
Affiliation:
Laboratory of Clinical Pharmacology, Istituto di Ricerche Farmacologiche “Mario Negri”
Fabio Colombo
Affiliation:
Laboratory of Clinical Pharmacology, Istituto di Ricerche Farmacologiche “Mario Negri”
Cesario Bellantuono
Affiliation:
Laboratory of Clinical Pharmacology, Istituto di Ricerche Farmacologiche “Mario Negri”
Paola Beretta
Affiliation:
San Carlo Borromeo Hospital, Milan
Anna Arduini
Affiliation:
San Carlo Borromeo Hospital, Milan
Tebaldo Galli
Affiliation:
San Carlo Borromeo Hospital, Milan
Gianni Tognoni
Affiliation:
Istituto di Ricerche Farmacologiche “Mario Negri”
*
Correspondence.

Summary

The strategy of high-dose intramuscular haloperidol as routinely applied in a general hospital psychiatric ward to 74 successive patients, 33 of whom stayed only up to seven days, and a further 34 up to 15 days, led to a complete recovery in only six, and complete lack of change in 23. Adverse reactions were recorded in 42, severe enough to stop treatment in eight; there were three deaths. In view of this risk-benefit analysis, systematic application of this high dose strategy to get a more rapid turnover of patients is unjustified.

Type
Research Article
Copyright
Copyright © 1984 The Royal College of Psychiatrists 

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References

Anderson, W. H. & Kuehnle, J. C. (1981) Diagnosis and early management of acute psychosis. New England Journal of Medicine, 305, 1128–30.Google Scholar
Anderson, W. H., Kuehnle, J. C. & Catanzano, D. M. (1976) Rapid treatment of acute psychosis. American Journal of Psychiatry, 133, 1076–8.Google ScholarPubMed
Ayd, F. J. Jr. (1977) Guidelines for using short-acting intramuscular neuroleptics for rapid neuroleptization. International Drug Therapy Newsletter, 12, 512.Google Scholar
Carter, R. G. (1977) Psychotolysis with haloperidol: Rapid control of the acutely disturbed psychotic patients. Diseases of the Nervous System, 38, 237–9.Google Scholar
Donlon, P. T., Hopkin, J. & Tupin, J. P. (1979) Overview: Efficacy and safety of the rapid neuroleptization method with injectable haloperidol. American Journal of Psychiatry, 136, 273–8.Google Scholar
Donlon, P. T. & Tupin, J. P. (1974) Rapid “digitalization” of decompensated schizophrenic patients with antipsychotic agents. American Journal of Psychiatry, 131, 310–12.Google Scholar
Ericksen, S. E., Hurt, S. W., Chang, S. et al. (1978) Haloperidol dose, plasma levels, and clinical response: A double-blind study. Psychopharmacology Bulletin 14, 1516.Google Scholar
Liberati, A., Andreani, A., Colombo, F., Confalonieri, C., Franceschi, S., La Vecchia, C. & Tognoni, G. (1982) Quality of breast-cancer care in Italian general hospitals. Lancet, ii, 258–60.Google Scholar
MacKay, A. V. (1981) Assessment of anti-psychotic drugs. British Journal of Clinical Pharmacology, 11, 225–36.Google Scholar
Mosher, L. R. (1982) Italy's revolutionary mental health law: An assessment. American Journal of Psychiatry, 139, 199203.Google Scholar
Neborsky, R., Janowsky, D., Munson, E. & Depry, D. (1981) Rapid treatment of acute psychotic symptoms with high- and low-dose haloperidol. Archives of General Psychiatry, 38, 195–9.Google Scholar
Oldham, A. J. & Bott, M. (1971) The management of excitement in a general hospital psychiatric ward by high dosage haloperidol. Acta Psychiatrica Scandinavica, 47, 369–76.CrossRefGoogle Scholar
Sangiovanni, F., Taylor, M. A., Abrams, R. & Gaztanaga, P. (1973) Rapid control of psychotic excitement states with intramuscular haloperidol. American Journal of Psychiatry, 130, 1155–6.Google Scholar
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