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A practical loading dose method for converting schizophrenic patients from oral to depot haloperidol therapy
The Journal of Clinical Psychiatry
|July 1, 1996
Summary
Converting schizophrenic patients from oral haloperidol to haloperidol decanoate (a long-acting injectable) is safe and effective. This study shows patients can switch to depot injections without issues, achieving therapeutic drug levels quickly.
Area of Science:
- Pharmacology
- Psychiatry
- Clinical Pharmacy
Background:
- Haloperidol decanoate is a long-acting injectable antipsychotic for schizophrenia.
- It addresses noncompliance with oral antipsychotic medications.
- Previous conversion studies lacked pharmacokinetic data.
Purpose of the Study:
- To prospectively evaluate the conversion process from oral haloperidol to haloperidol decanoate.
- To assess the safety and efficacy of this conversion strategy.
Main Methods:
- Twenty-one schizophrenia patients were switched from oral haloperidol to haloperidol decanoate injections.
- Initial dosing was weekly, then intervals extended to bi-weekly and monthly.
- Plasma haloperidol levels were monitored using HPLC; clinical status was assessed.
Main Results:
- All patients completed the 4-week conversion without adverse events.
- Mean plasma haloperidol concentrations with depot injections became comparable to oral therapy by week 3.
- Steady-state plasma concentrations were achieved by week 4.
Conclusions:
- Schizophrenia patients can be safely and easily converted from oral haloperidol to haloperidol decanoate depot injections.
- This conversion method is well-tolerated and achieves therapeutic drug levels.
- Further research on haloperidol decanoate conversion using plasma concentrations is warranted.