Plasma haloperidol levels and clinical effects in schizophrenia and schizoaffective disorder.
Plasma haloperidol levels and clinical effects in schizophrenia and schizoaffective disorder.
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DOI：
10.1001/archpsyc.1995.03950220047010
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发表时间：
1995-10
影响因子：
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通讯作者：
Jan Volavka;Thomas B. Cooper;P. Czobor;Morris Meisner
中科院分区：
文献类型：
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作者：
Jan Volavka;Thomas B. Cooper;P. Czobor;Morris Meisner
氟哌啶醇的血浆浓度在5 - 11 ng/mL之间可能是急性加重的精神分裂症的临床最佳治疗浓度，但这一治疗窗的证据并不一致。方法对65例急性发作期精神分裂症或情感性精神障碍患者采用双盲对照研究，连续两个3周。目标血浆水平为：“低”（2 ng/mL）和“中等”（10 ng/mL）。受试者被随机分配到4个治疗序列（低-低、低-中、中-中或中-低）。结果：在前3周，氟哌啶醇的抗精神病疗效随着血浆浓度增加至约12 ng/mL而增加。在第二个3周，血浆水平的降低减少了阴性症状。结论：对于大多数患者，在治疗的前3周，血浆水平不超过12 ng/mL会产生最佳结果。随后降低血浆水平可改善阴性症状。
BACKGROUND Plasma haloperidol levels between 5 and 11 ng/mL may be clinically optimal for acutely exacerbated schizophrenia, but the evidence for this therapeutic window has been inconsistent. METHODS Haloperidol was administered in a double-blind manner during two consecutive 3-week experimental periods to 65 patients with acutely exacerbated schizophrenia or schizoaffective disorder. Two plasma levels were targeted: "low" (2 ng/mL) and "moderate" (10 ng/mL). The subjects were randomly assigned to four treatment sequences (low-low, low-moderate, moderate-moderate, or moderate-low). RESULTS In the first 3 weeks, the antipsychotic efficacy of haloperidol increased with plasma levels up to approximately 12 ng/mL. In the second 3 weeks, decrease of plasma levels reduced negative symptoms. CONCLUSION For most patients, plasma levels not exceeding 12 ng/mL yield the best results in the first 3 weeks of treatment. Subsequent lowering of the plasma levels may improve negative symptoms.