[Deterioration of schizoaffective disorder due to an interaction between haloperidol and carbamazepine].
A 40-year-old woman with a schizoaffective disorder was initially treated with lithium carbonate and haloperidol decanoate, but after three years the lithium was replaced with carbamazepine. Following this, her performance deteriorated over several years despite increasing dosages of haloperidol. After withdrawal of the carbamazepine a remarkable recovery occurred. A pharmacokinetic interaction between haloperidol and carbamazepine, which results in decreased haloperidol blood levels, provides a good explanation of this clinical picture. This clinically relevant interaction should be incorporated into pharmacovigilance systems.
Cohen
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D
Rijngeest Groep, Langevelderweg 27, 2211 AB Noordwijkerhout. dcohen@rijngeestgroep.nl
Diemont
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WL
D000328:Adult; D018692:Antimanic Agents / Q000009:adverse effects* / Q000493:pharmacokinetics; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000493:pharmacokinetics*; D002220:Carbamazepine / Q000009:adverse effects* / Q000493:pharmacokinetics; D004347:Drug Interactions; D005260:Female; D006220:Haloperidol / Q000009:adverse effects / Q000493:pharmacokinetics*; D006801:Humans; D011618:Psychotic Disorders / Q000188:drug therapy*
D018692:Antimanic Agents; D014150:Antipsychotic Agents; D002220:Carbamazepine; D006220:Haloperidol