Archives of General Psychiatry · 1991 · 383 citations · 25 references
After determining individual neuroleptic threshold doses of haloperidol, 106 patients with schizophrenia or schizoaffective disorder were treated openly at a mean dose of 3.7 mg d⁻¹ for two weeks. The remaining 95 patients were then randomized, double‑blind, to receive either a higher haloperidol dose (mean 11.6 mg d⁻¹) or to continue the threshold dose (mean 3.4 mg d⁻¹) for an additional two weeks. Among the 58 patients maintained on threshold doses, 72 % clinically recovered within five weeks, whereas the higher‑dose group showed no additional improvement in psychosis, a modest increase in hostility, and a regular rise in distressing extrapyramidal side effects.
• After individual determination of neuroleptic threshold (NT) doses of haloperidol, 106 patients with schizophrenia or schizoaffective disorder (Research Diagnostic Criteria) were treated openly at such doses (mean, 3.7± 2.3 mg/d) for 2 weeks. Ten responding patients were discharged and unavailable for follow-up or refused subsequent randomization, and one nonresponding patient refused randomization. The remaining 95 responding or nonresponding patients were then randomly assigned, double-blind, to a dosage of haloperidol two to 10 times higher (mean, 11.6 ±4.7 mg/d) or to a continuing NT dosage (mean, 3.4±2.3 mg/d) for another 2 weeks. Of the 58 patients exposed only to NT dosages of haloperidol, 72% clinically recovered within the 5-week trial. Higher dosages given to 47 patients did not lead to greater improvement in measures of psychosis, but did produce slightly greater declines in measures of hostility. Higher dosages did regularly lead to significant increases in distressing extrapyramidal side effects.
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Clozapine for the Treatment-Resistant Schizophrenic
John M. Kane · Archives of General Psychiatry · 1988 · 4.1K citations
Arthur Rifkin · Archives of General Psychiatry · 1975 · 259 citations