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Haloperidol discontinuation for people with schizophrenia
Adib Essali1, Khaled Turkmani, Shaimaa Aboudamaah
1Community Mental Health, Counties Manukau Health, Building 6, 17 Lambie Drive,, Manukau, Auckland, New Zealand, 2241.
The Cochrane Database of Systematic Reviews
|April 22, 2019
Summary
Stopping haloperidol in stable schizophrenia patients increases relapse risk and reduces global state improvement. Patient satisfaction remained similar, but evidence quality is very low, necessitating further research on adverse effects.
Area of Science:
- Psychiatry
- Clinical Pharmacology
- Evidence Synthesis
Background:
- Schizophrenia is a chronic, disabling mental illness.
- Haloperidol, a first-generation antipsychotic, treats schizophrenia but has side effects.
- Research on discontinuing haloperidol in stable patients is limited.
Purpose of the Study:
- To systematically review the effects of discontinuing haloperidol in stable schizophrenia patients.
Main Methods:
- Searched trial registers for randomized controlled trials (RCTs) comparing haloperidol discontinuation with continuation.
- Included 5 RCTs with 232 participants, replacing haloperidol with placebo for discontinuation.
- Analyzed dichotomous data using fixed-effect models and assessed risk of bias.
Main Results:
- Haloperidol discontinuation increased the risk of relapse (RR 1.80) and reduced global state improvement (RR 2.06).
- Participant satisfaction was similar between groups (RR 0.13).
- Evidence quality was very low due to methodological limitations; no usable data on adverse effects were reported.
Conclusions:
- Limited, very low-quality evidence suggests haloperidol discontinuation increases relapse risk.
- Firm conclusions cannot be drawn due to study limitations and lack of reported adverse effect data.
- Further well-designed trials are needed to investigate the benefits and harms of haloperidol discontinuation.
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