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Haloperidol versus placebo for schizophrenia.

C B Joy1, C E Adams, S M Lawrie

  • 1University of Leeds, Department of Psychiatry & Behavioural Sciences, 15-19 Hyde Terrace, Leeds, UK. claireirving@btopenworld.com

The Cochrane Database of Systematic Reviews
|October 21, 2006
PubMed
Summary
This summary is machine-generated.

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Haloperidol effectively manages schizophrenia symptoms, but carries a high risk of movement disorders. Consider alternatives if available due to potential adverse effects like parkinsonism and acute dystonia.

Area of Science:

  • Psychiatry and Pharmacology
  • Clinical Trial Analysis

Background:

  • Haloperidol, initially developed for anesthesia, emerged as an antipsychotic due to its efficacy in managing psychosis.
  • Its effects on hallucinations, delusions, and aggressive behavior led to its widespread clinical adoption.

Purpose of the Study:

  • To systematically evaluate the clinical effectiveness of haloperidol versus placebo in treating schizophrenia.
  • To assess haloperidol's impact on clinical and social response, relapse rates, and adverse effects.

Main Methods:

  • Conducted a comprehensive literature search of multiple databases (e.g., MEDLINE, EMBASE, PsycLIT) from inception to 1998, with an update in 2005.
  • Included randomized controlled trials (RCTs) comparing oral haloperidol with placebo in patients with schizophrenia or similar psychoses.

Related Experiment Videos

  • Analyzed data using intention-to-treat principles, calculating relative risks (RR) and number needed to treat/harm (NNT/NNH).

    • Main Results:

    • Twenty-one RCTs involving 1519 participants were included.
    • Haloperidol demonstrated significant improvement in symptoms within the first six weeks (NNT=3) and over 6-24 weeks.
    • However, haloperidol significantly increased the risk of acute dystonia (NNH=5), akathisia (NNH=7), and parkinsonism (NNH=3).

    Conclusions:

    • Haloperidol is an effective antipsychotic but is associated with a high incidence of movement disorders.
    • Its use may be justified when no other treatment options exist for severe schizophrenia.
    • Alternative antipsychotics with a lower risk of adverse effects are preferable when available.