[Disagreement in standardized haloperidol treatment in comparison with "adequate individual dosage" of acutely schizophrenic patients]

Abstract

Experimental double-blind trials were performed to establish whether individual neuroleptic treatment of acute schizophrenic disorders is more effective and has fewer side effects than standard therapy. For this purpose, a group of 30 patients was treated with 10 mg haloperidol/day for 14 days, while a further group of 30 patients receined 20 mg haloperidol/day for the same period. Thirty patients in a third group were treated for 14 days with an individual haloperidol dose that was matched to the psychopathological findings. Allocation of the patients to the treatment groups was done on a random basis. In the individually treated group the dosage was determined by a senior psychiatrist at the hospital who was not involved in collecting the data of the investigation; neither the nursing staff nor the physicians involved in thus study were informed of the dosages. The psychological findings were recorded by means of the BPRS and the global assessment of the physician (CGI) on days 0, 7, and 14. The extrapyramidal side effects were established with the aid of the Simpson scale on days 0, 7, and 14. No superiority of the individually matched treatment over standardized treatment was demonstrated, either for the therapeutic target parameters or for the side effects. On the contrary, the groups treated with fixed doses were found to exhibit somewhat better results. These findings are discussed with respect to their significance for treatment.