Plasma haloperidol levels drawn at neuroleptic threshold doses: a pilot study.
Plasma haloperidol levels drawn at neuroleptic threshold doses: a pilot study.
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在精神安定剂阈剂量下绘制的血浆氟哌啶醇水平：一项试点研究。
DOI：
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发表时间：
1986
期刊：
影响因子：
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通讯作者：
D. Greenblatt
中科院分区：
文献类型：
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作者：
R. Shader;D. Greenblatt
每日氟哌啶醇剂量的33个新入院的，急性精神病性精神分裂症患者迅速调整到一个点，在轻微的运动功能减退，刚性首次出现在临床检查（抗精神病药物的阈值）。超过抗精神病药阈值的氟哌啶醇平均日剂量为4.2 +/- 2.4 mg/天。在这些抗精神病药物阈值剂量下获得的血浆氟哌啶醇水平集中在平均值4.9 +/- 2.9 ng/ml左右。该血浆氟哌啶醇水平分布与血浆氟哌啶醇水平的治疗有效范围的拟定下限广泛重叠，但其低于以高频率（大于10 ng/ml）出现粗大锥体外系副作用的范围。我们的患者中有67%在3周内表现出中度或更大的治疗改善，与标准抗精神病药物剂量的预期疗效率相同。作者提出，抗精神病药阈值是一种容易获得的临床标志物，其确定了能够产生治疗反应且相关的粗锥体外系副作用最小的血浆氟哌啶醇水平范围。
The daily haloperidol doses of 33 newly admitted, acutely psychotic schizophrenic patients were rapidly adjusted to a point at which slight hypokinesia-rigidity first appeared on clinical examination (the neuroleptic threshold). The mean daily haloperidol dose at which the neuroleptic threshold was crossed was 4.2 +/- 2.4 mg/day. The plasma haloperidol levels obtained at these neuroleptic threshold doses clustered around a mean of 4.9 +/- 2.9 ng/ml. This plasma haloperidol level distribution extensively overlaps the proposed lower boundaries for the therapeutically effective range of plasma haloperidol levels, but it is below the range in which coarse extrapyramidal side effects appear in high frequency (greater than 10 ng/ml). Sixty-seven percent of our patients demonstrated moderate or greater therapeutic improvement within 3 weeks of treatment at neuroleptic threshold doses, a therapeutic efficacy rate identical to that expected with standard neuroleptic doses. The authors propose that the neuroleptic threshold is a readily available clinical marker which identifies a range of plasma haloperidol levels capable of producing therapeutic response with minimal associated coarse extrapyramidal side effects.