Significance of Neuroleptic Dose and Plasma Level in the Pharmacological Treatment of Psychoses

Erythropoietin Prevents Haloperidol Treatment-Induced Neuronal Apoptosis through Regulation of BDNF

“…Such a time period of HAL exposure in humans has been associated with a broad range of adverse neuropathological (basal ganglia and diffuse loss of dendritic and synaptic loss) and neurobehavioral (extrapyramidal symptoms, tardive dyskinesia) effects (Cadet and Lohr, 1989;Jeste and Wyatt, 1982;Casey, 1985). We selected the 2.0 mg/kg/day dose of HAL in our studies since this dose was previously found to establish clinically relevant (Baldessarini et al, 1988) steadystate plasma levels in the rat . It is also important to point out that under similar dosing conditions the levels of HAL were reported to be 10 times higher in the brain than plasma levels (Kornhuber et al, 2006).…”

“…Rats (N ¼ 6-8 per group) were administered HAL, HAL and rhEPO, or vehicle for 6 weeks. The HAL dose (2.0 mg/kg/ day) was selected based on previous studies where this dose was found to establish clinically relevant (Baldessarini et al, 1988) steady-state plasma levels in the rat . This dose is also comparable to the optimal dose to cause pharmacological effects (Skarsfeldt, 1996;Didriksen, 1995;Bymaster et al, 1996).…”

Inpatient Antipsychotic Drug Use in 1998, 1993, and 1989

“…In contrast to earlier American practices, mean chlorpromazine-equivalent daily doses fell by the late 1980s, to accord with standard international practices, and conservative dosing was sustained into the early 1990s (2,3). More recently, growing numbers of atypical antipsychotics have entered clinical use, along with other innovative treatments (4).…”

Neuroleptización rápida: una revisión

“…Además, 35% de los pacientes que recibieron 20 mg/ día manifestaron su deseo de abandonar el tratamiento, contra sólo el 4% de los que recibieron 5 ó 10 mg/día. Se ha postulado la existencia de una ventana terapéutica, más allá de la cual no se obtendrían resultados o inclusive podrían exacerbarse los síntomas psicóticos; esta ventana sería de 5-20 mg/día para el haloperidol 31,32 . 35 encontraron en una población de 88 esquizofrénicos en Lima y Trujillo (Perú), una dosis media de clozapina de 242.8 mg/día, menor que la descrita en estudios anteriores.…”

“…Muchos autores coinciden actualmente en que la neuroleptización rápida es un método que ya no debe utilizarse como tratamiento de primera línea, pues tiene una mayor probabilidad de producir síntomas colaterales tales como distonía aguda, síndrome parkinsoniano, acatisia, síndrome neuroléptico maligno e hipotensión ortostática, entre otros, y no ha demostrado fehacientemente su superioridad frente a las dosis convencionales de antipsicóticos 1,21,31,37,38,[40][41][42][56][57][58][59][60][61][62][63][64] .…”