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Is there a relationship between antipsychotic blood levels and their clinical efficacy? An analysis of studies design and methodology.
de Oliveira, I R; Dardennes, R M; Amorim, E S; Diquet, B; de Sena, E P; Moreira, E C; de Castro-e-Silva, E J; Payan, C; Fermanian, J; Marcílio, C.
Afiliação
  • de Oliveira IR; Department of Pharmacology and Physiology, Federal University of Bahia, Salvador-Bahia, Brazil.
Fundam Clin Pharmacol ; 9(5): 488-502, 1995.
Article em En | MEDLINE | ID: mdl-8617413
There are now more than 50 studies concerning neuroleptic blood levels and clinical outcome relationships. Haloperidol, the most studied, is the only antipsychotic permitting some conclusions. A number of authors suggest that the striking lack of agreement between different studies results from heterogeneity of their quality. Here, we have used a scoring system for assessing the quality of those studies. According to this system, none (0/14) of the studies having a score < 0.60 was able to show a therapeutic window, as compared to 53% (10/19) of those having a score > or = 0.60 (p = 0.002, Fisher exact test). Also, the studies able to identify the presence of a therapeutic window during haloperidol treatment were those having sample size > 20 (p = 0.06) and those whose patients were treated with fixed doses (p = 0.02). The diagnosis of schizophrenia in the studies seems not to be an exclusive condition, as compared with those also including schizophreniform and schizoaffective disorders (p = 0.12). Our qualitative analysis of haloperidol blood level publications seem to indicate that an upper limit may exist for haloperidol efficacy; values above this limit seem not to provide any supplementary clinical improvement and may even reduce therapeutic effect.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Esquizofrenia / Antipsicóticos / Haloperidol Tipo de estudo: Prognostic_studies / Qualitative_research / Systematic_reviews Limite: Humans Idioma: En Revista: Fundam Clin Pharmacol Assunto da revista: FARMACOLOGIA Ano de publicação: 1995 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Esquizofrenia / Antipsicóticos / Haloperidol Tipo de estudo: Prognostic_studies / Qualitative_research / Systematic_reviews Limite: Humans Idioma: En Revista: Fundam Clin Pharmacol Assunto da revista: FARMACOLOGIA Ano de publicação: 1995 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido