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Journal of Psychopharmacology (Oxford,... Oct 2023Expert consensus-based clinically equivalent dose estimates and dosing recommendations can provide valuable support for the use of drugs for psychosis in clinical...
BACKGROUND
Expert consensus-based clinically equivalent dose estimates and dosing recommendations can provide valuable support for the use of drugs for psychosis in clinical practice and research.
AIMS
This second International Consensus Study of Antipsychotic Dosing provides dosing equivalencies and recommendations for newer drugs for psychosis and previously reported drugs with low consensus.
METHODS
We used a two-step Delphi survey process to establish and update consensus with a broad, international sample of clinical and research experts regarding 26 drug formulations to obtain dosing recommendations (start, target range, and maximum) and estimates of clinically equivalent doses for the treatment of schizophrenia. Reference agents for equivalent dose estimates were oral olanzapine 20 mg/day for 15 oral and 7 long-acting injectable (LAI) agents and intramuscular haloperidol 5 mg for 4 short-acting injectable (SAI) agents. We also provide a contemporary list of equivalency estimates and dosing recommendations for a total of 44 oral, 16 LAI, and 14 SAI drugs for psychosis.
RESULTS
Survey participants ( = 72) from 24 countries provided equivalency estimates and dosing recommendations for oral, LAI, and SAI formulations. Consensus improved from survey stages I to II. The final consensus was highest for LAI formulations, intermediate for oral agents, and lowest for SAI formulations of drugs for psychosis.
CONCLUSIONS
As randomized, controlled, fixed, multiple-dose trials to optimize the dosing of drugs for psychosis remain rare, expert consensus remains a useful alternative for estimating clinical dosing equivalents. The present findings can support clinical practice, guideline development, and research design and interpretation involving drugs for psychosis.
Topics: Humans; Antipsychotic Agents; Schizophrenia; Psychotic Disorders; Haloperidol; Olanzapine; Delayed-Action Preparations
PubMed: 37842908
DOI: 10.1177/02698811231205688 -
Postepy Higieny I Medycyny... Oct 2015Haloperydol is a butyrophenone, typical neuroleptic agent characterized as a high antipsychotics effects in the treatment of schizophrenia and in palliative care to... (Review)
Review
Haloperydol is a butyrophenone, typical neuroleptic agent characterized as a high antipsychotics effects in the treatment of schizophrenia and in palliative care to alleviation many syndromes, such as naursea, vomiting and delirium. Clinical problems occurs during and after administration of the drug are side effects, particularly extrapyrramidal symptoms (EPS). The neurotoxicity of haloperydol may be initiated by the cationic metabolites of haloperydol, HPP+, RHPP+, formed by oxidation and reduction pathways. These metabolites are transported by human organic cation transporters (hOCT) to several brain structures for exapmle, in substantia nigra, striatum, caudate nucleus, hippocampus. After reaching the dopaminergic neurons inhibits mitochondrial complex I, evidence for free radical involvement, thus leading to neurodegeneration.
Topics: Antipsychotic Agents; Biotransformation; Brain; Delirium; Haloperidol; Humans; Nausea; Neurodegenerative Diseases; Neurotoxicity Syndromes; Schizophrenia
PubMed: 26561842
DOI: 10.5604/17322693.1175009 -
International Journal of Molecular... Jul 2022Aberrant neurogenesis in the subventricular zone (SVZ) and hippocampus (HIP) contributes to schizophrenia pathogenesis. Haloperidol (HAL) and olanzapine (OLA), commonly...
Aberrant neurogenesis in the subventricular zone (SVZ) and hippocampus (HIP) contributes to schizophrenia pathogenesis. Haloperidol (HAL) and olanzapine (OLA), commonly prescribed antipsychotics for schizophrenia treatment, affect neurogenesis too. The effect of HAL and OLA on an mHippoE-2 cell line was studied in vitro where we measured the cell number and projection length. In vivo, we studied the gene expression of , , , and in the SVZ and HIP in an MK-801-induced animal schizophrenia model. Cells were incubated with HAL, OLA, and MK-801 for 24, 48, and 72 h. Animals were injected for 6 days with saline or MK801 (0.5 mg/kg), and from the 7th day with either vehicle HAL (1 mg/kg) or OLA (2 mg/kg), for the next 7 days. In vitro, HAL and OLA dose/time-dependently suppressed cells' proliferation and shortened their projection length. HAL/OLA co-treatment with MK-801 for 24 h reversed HAL's/OLA's inhibitory effect. In vivo, HAL and OLA suppressed and genes' expression in the HIP and SVZ. MK-801 decreased and genes' expression in the HIP and OLA prevented this effect. The data suggest that subchronic HAL/OLA treatment can inhibit and expression. In an MK-801 schizophrenia model, OLA reversed the MK-801 inhibitory effect on and and HAL reversed the effect on DCX expression; however, only in the HIP.
Topics: Animals; Antipsychotic Agents; Benzodiazepines; Cell Proliferation; Disease Models, Animal; Dizocilpine Maleate; Haloperidol; Hippocampus; Olanzapine; Schizophrenia
PubMed: 35887056
DOI: 10.3390/ijms23147711 -
Anesthesia Progress Sep 2020
Topics: Droperidol; Humans; Postoperative Nausea and Vomiting
PubMed: 32992339
DOI: 10.2344/anpr-67-03-14 -
BMJ Clinical Evidence Jul 2009Delirium is common in the last weeks of life, occurring in 26% to 44% of people with advanced cancer in hospital, and in up to 88% of people with terminal illness in the... (Review)
Review
INTRODUCTION
Delirium is common in the last weeks of life, occurring in 26% to 44% of people with advanced cancer in hospital, and in up to 88% of people with terminal illness in the last days of life.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of interventions at the end of life in people with delirium caused by underlying terminal illness? We searched: Medline, Embase, The Cochrane Library, and other important databases up to February 2009 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found three systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review, we present information relating to the effectiveness and safety of the following interventions: artificial hydration; barbiturates; benzodiazepines; haloperidol; opioid switching; phenothiazines; and propofol.
Topics: Analgesics, Opioid; Antipsychotic Agents; Barbiturates; Delirium; Haloperidol; Humans; Incidence; Neoplasms; Prospective Studies
PubMed: 21696645
DOI: No ID Found -
Medical Principles and Practice :... 2018The aim of this systematic review and meta-analysis was to investigate whether or not the use of haloperidol could reduce the incidence of delirium in adult patients. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The aim of this systematic review and meta-analysis was to investigate whether or not the use of haloperidol could reduce the incidence of delirium in adult patients.
SUBJECTS AND METHODS
PubMed, Embase, the Cochrane Library, Elsevier, Wiley, and Ovid were searched for randomized controlled trials and prospective interventional cohort studies that compared haloperidol with placebo for delirium prophylaxis or with second generation antipsychotics for delirium treatment. The primary end point was the incidence and severity of delirium. After reviewing 272 relevant articles, 10 studies with 1,861 patients were finally included (haloperidol vs. placebo in 8 studies [n = 1,734], and haloperidol vs. second-generation antipsychotics in 2 studies [n = 127]). Revman 5.3 was used for the data analysis.
RESULTS
Compared with placebo, a high dose of prophylactic haloperidol (≥5 mg/day) may help reduce the incidence of delirium in surgical patients (risk ratio 0.50, 95% CI 0.32, 0.79). There were no differences in the duration of delirium, QTc interval prolongation, extrapyramidal symptoms, intensive care unit stay, hospital stay, or mortality between the haloperidol and placebo groups. For delirium treatment, haloperidol exhibited similar effects as the second-generation antipsychotics.
CONCLUSIONS
In this study, the limited available data revealed that prophylaxis haloperidol at a dose of ≥5 mg/day might help reduce delirium in adult surgical patients. Further outcome studies with larger sample sizes are required to confirm these findings.
Topics: Adult; Antipsychotic Agents; Delirium; Female; Haloperidol; Humans; Male; Postoperative Complications
PubMed: 29518791
DOI: 10.1159/000488243 -
BMC Medical Research Methodology May 2023PONV reduces patient satisfaction and increases hospital costs as patients remain in the hospital for longer durations. In this study, we build a preliminary artificial...
OBJECTIVE
PONV reduces patient satisfaction and increases hospital costs as patients remain in the hospital for longer durations. In this study, we build a preliminary artificial intelligence algorithm model to predict early PONV in patients.
METHODS
We use R for statistical analysis and Python for the machine learning prediction model.
RESULTS
Average characteristic engineering results showed that haloperidol, sex, age, history of smoking, and history of PONV were the first 5 contributing factors in the occurrence of early PONV. Test group results for artificial intelligence prediction of early PONV: in terms of accuracy, the four best algorithms were CNNRNN (0.872), Decision Tree (0.868), SVC (0.866) and adab (0.865); in terms of precision, the three best algorithms were CNNRNN (1.000), adab (0.400) and adab (0.868); in terms of AUC, the top three algorithms were Logistic Regression (0.732), SVC (0.731) and adab (0.722). Finally, we built a website to predict early PONV online using the Streamlit app on the following website: ( https://zhouchengmao-streamlit-app-lsvc-ad-st-app-lsvc-adab-ponv-m9ynsb.streamlit.app/ ).
CONCLUSION
Artificial intelligence algorithms can predict early PONV, whereas logistic regression, SVC and adab were the top three artificial intelligence algorithms in overall performance. Haloperidol, sex, age, smoking history, and PONV history were the first 5 contributing factors associated with early PONV.
Topics: Humans; Artificial Intelligence; Postoperative Nausea and Vomiting; Deep Learning; Haloperidol; Algorithms; Machine Learning
PubMed: 37259031
DOI: 10.1186/s12874-023-01955-z -
Postgraduate Medical Journal Apr 1968
Review
Topics: Amphetamine; Antidepressive Agents; Barbiturates; Chlorpromazine; Hallucinogens; Haloperidol; Hypnotics and Sedatives; Imipramine; Lithium; Lysergic Acid Diethylamide; Monoamine Oxidase Inhibitors; Phenothiazines; Tranquilizing Agents
PubMed: 4870139
DOI: 10.1136/pgmj.44.510.286 -
CMAJ : Canadian Medical Association... Sep 2002
Topics: Antiemetics; Droperidol; Electrocardiography; Humans; Postoperative Nausea and Vomiting; United States; United States Food and Drug Administration
PubMed: 12240805
DOI: No ID Found -
American Family Physician May 1998The etiology of stuttering is controversial. The prevailing theories point to measurable neurophysical dysfunctions that disrupt the precise timing required to produce... (Review)
Review
The etiology of stuttering is controversial. The prevailing theories point to measurable neurophysical dysfunctions that disrupt the precise timing required to produce speech. Stuttering is a common disorder that usually resolves by adulthood. Almost 80 percent of children who stutter recover fluency by the age of 16 years. Mild stuttering is self-limited, but more severe stuttering requires speech therapy which is the mainstay of treatment. Delayed auditory feedback and computer-assisted training are currently used to help slow down speech and control other speech mechanisms. Pharmacologic therapy is seldom used, although haloperidol has been somewhat effective.
Topics: Haloperidol; Humans; Stuttering
PubMed: 9606307
DOI: No ID Found