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Theodore Van Putten, MD; Stephen R. Marder, MD; Jim Mintz, PhD

Arch Gen Psychiatry. 1990;47(8):754-758.

Abstract
• Eighty newly admitted or readmitted men with DSM-III schizophrenia were assigned to receive 5, 10, or 20 mg/d of haloperidol for 4 weeks. Staff were not "blind" to dose. By Clinical Global Impression Scale ratings, the 20-mg dose appeared to be superior to both the 5- and 10-mg doses for the first 2 weeks of treatment but not thereafter. On the Brief Psychiatric Rating Scale Schizophrenia factor, the 20-mg dose was superior to the 5-mg dose throughout the trial and tended to be marginally superior to the 10-mg dose after the first 2 weeks of treatment. By the second week of treatment, however, the group receiving the 20-mg dose deteriorated significantly with regard to Brief Psychiatric Rating Scale ratings of Withdrawal-Retardation (blunted affect, motor retardation, and emotional withdrawal) as well as akinesia and akathisia ratings. Furthermore, 35% of patients given 20 mg/d of haloperidol insisted on leaving the hospital against medical advice vs only 4% of those given 5 or 10 mg/d of haloperidol. A 20-mg/d dose of haloperidol, therefore, may have substantial "psychotoxic" effects by the second week of treatment.

Author Affiliations
From the UCLA/West Los Angeles Veterans Affairs Medical Center.

Footnotes
Accepted for publication April 7, 1990.

Reprint requests to Veterans Affairs Medical Center, 11301 Wilshire Blvd, Bldg 210C, Los Angeles, CA 90073 (Dr Van Putten).

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