Neuroleptic monitoring: relation between antipsychotic efficiency and radioreceptor assay of serum haloperidol.
OBJECTIVE
We report preliminary results from use of a radioreceptor assay (RRA) to measure serum haloperidol levels and their relation to clinical response and adverse effects in 19 psychotic patients with positive symptoms treated with haloperidol.


METHODS
Blood samples were taken on Days 7, 14 and 21. Clinical evaluation was based on the PANSS, and UKU scales. The D2 antidopaminergic RRA was used to measure haloperidol serum levels.


RESULTS
Our results show a correlation between psychosis with positive symptoms assessed by positive scores in the PANSS and the serum drug level measured by RRA concentrations. The observed relationship made it possible to establish a therapeutic serum range of haloperidol equivalents 15-30 ng/ml-1. This range contained no "non-responders". Analysis of the correlation between each item on the positive subscale of the PANSS and the RRA concentration suggested that there was no specific symptom of psychosis closely related to RRA concentration during the first 15 days of treatment. In the third week, however, certain specific symptoms were closely connected to the RRA concentration.


CONCLUSIONS
From these results, it can be concluded that antipsychotic activity can be related to blockade of serum D2 dopamine receptors. In future would be desirable to monitor neuroleptic treatment in this way. The study also showed that the antipsychotic treatment did not correct any specific component of the psychosis during the first stage of the treatment but that it did so at later times.
Odou
P
P
Laboratoire de Pharmacologie, Pharmacocinetique, PharmacieClinique, Facult-e des Sciences Pharmaceutiques et Biologiques, Universit-e de Lille II, France.
Vaiva
G
G
Luyckx
M
M
Brunet
C
C
Dine
T
T
Gressier
B
B
Cazin
M
M
Cazin
J C
JC
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000097:blood* / Q000627:therapeutic use; D001667:Binding, Competitive; D065127:Dopamine D2 Receptor Antagonists; D004311:Double-Blind Method; D005260:Female; D006220:Haloperidol / Q000009:adverse effects / Q000097:blood* / Q000627:therapeutic use; D006801:Humans; D007553:Isotope Labeling; D008297:Male; D008875:Middle Aged; D011485:Protein Binding; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000097:blood* / Q000188:drug therapy; D011869:Radioligand Assay; D017448:Receptors, Dopamine D2 / Q000097:blood; D012559:Schizophrenia / Q000097:blood* / Q000188:drug therapy; D013134:Spiperone / Q000097:blood; D014316:Tritium
D014150:Antipsychotic Agents; D065127:Dopamine D2 Receptor Antagonists; D017448:Receptors, Dopamine D2; D014316:Tritium; D013134:Spiperone; D006220:Haloperidol