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Psychotic exacerbation with haloperidol.

F L Tornatore, D Lee, J J Sramek

Drug Intelligence & Clinical Pharmacy

|March 1, 1981

Summary

Increasing haloperidol dosage worsened schizophrenic symptoms in a patient, suggesting a potential "therapeutic window" for neuroleptic medications. This rare exacerbation highlights the need to consider alternative causes for symptom worsening.

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Area of Science:

Psychiatry
Pharmacology

Background:

Schizophrenia treatment often involves antipsychotic medications like haloperidol.
Dosage adjustments are common, but paradoxical effects are rarely reported.

Observation:

A patient experienced worsening schizophrenic symptoms after haloperidol dosage increases.
This psychotic exacerbation is unusual and infrequently documented in medical literature.

Findings:

The case suggests neuroleptic medications, similar to some antidepressants, might have a "therapeutic window."
This implies that exceeding an optimal dosage can lead to adverse effects like symptom worsening.

Implications:

Clinicians should consider the possibility of a therapeutic window when adjusting haloperidol dosages.
Differential diagnosis for worsening psychosis must include akathisia and anticholinergic psychosis.

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