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Updated: May 5, 2026

Paw-Print Analysis of Contrast-Enhanced Recordings PrAnCER: A Low-Cost, Open-Access Automated Gait Analysis System for Assessing Motor Deficits

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Haloperidol versus placebo for schizophrenia.

Clive E Adams¹, Hanna Bergman, Claire B Irving

¹Cochrane Schizophrenia Group, The University of Nottingham, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road,, Nottingham, UK, NG7 2TU.

The Cochrane Database of Systematic Reviews

|November 19, 2013

Summary

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

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Area of Science:

Psychiatry
Pharmacology
Clinical Trials

Background:

Haloperidol, developed in the 1950s, emerged as an antipsychotic due to its effects on psychosis symptoms.
Its efficacy in managing hallucinations, delusions, and agitation led to its widespread clinical use.

Purpose of the Study:

To systematically evaluate the clinical effectiveness of haloperidol against placebo for schizophrenia and similar serious mental illnesses.
To assess key outcomes including clinical response, relapse rates, and adverse effects.

Main Methods:

A comprehensive search of multiple electronic databases (e.g., MEDLINE, EMBASE, PsycLIT) was conducted up to 1998, with an update in 2012.
Included were randomized controlled trials comparing oral haloperidol with placebo in patients diagnosed with schizophrenia or similar non-affective psychotic disorders.
Data analysis involved risk ratios for dichotomous outcomes and mean differences for continuous outcomes, using a fixed-effect model and GRADE approach for quality assessment.

Main Results:

Twenty-five trials involving 4651 participants were included. Haloperidol showed moderate-quality evidence of improved symptoms within the first six weeks and up to six months compared to placebo.
However, moderate-quality evidence indicated a significant increase in adverse effects, including parkinsonism, akathisia, and acute dystonia.
Relapse rates favored haloperidol, but with very low-quality evidence. Completion rates were similar, with a marginal benefit for haloperidol in short-term trials.

Conclusions:

Haloperidol is a potent antipsychotic effective in treating schizophrenia, particularly when other options are limited.
Its significant propensity for causing movement disorders necessitates careful consideration, favoring alternatives with better safety profiles when available.
The drug's side effect profile suggests it should be used cautiously and potentially avoided as a control in new antipsychotic trials.