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Journal of Psychopharmacology
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Determining the optimal dose of haloperidol in first-episode psychosis

Piet Oosthuizen

Department of Psychiatry, University of Stellenbosch, Medical School, PO Box 19063, Tygerberg 7505, Cape Town, South Africa pieto{at}samedical.co.za

Robin A. Emsley

Jadri Turner

Natasha Keyter

Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa

Uncertainty exists as to the most appropriate dose of haloperidol in first-episode psychosis. This study set out to determine whether ultra-low doses of haloperidol could successfully treat patients with first-episode psychosis. Thirty-five patients with a first episode of psychosis were treated with haloperidol in an open label, fixed protocol over a 12-week period with doses restricted to 1 mg per day for the first 4 weeks. Twenty-nine (83%) remained on haloperidol after 12 weeks at a mean dose of 1.78 mg per day, 16 (55%) had stabilized on 1 mg/day or less. The mean percentage reduction in Positive and Negative Symptom Scale score between baseline and 6 and 12 weeks was 30.3% (SD 20.9%) and 41.4% (SD 16.6%), respectively. There were no significant differences in mean extrapyramidal symptom ratings between baseline and 12 weeks. Ultra-low doses of haloperidol are effective and well tolerated in first-episode psychosis. Initial doses should be maintained for a sufficient period of time to allow for the medication to take full effect.

Key Words: first-episode • haloperidol • psychosis • schizophrenia

Journal of Psychopharmacology, Vol. 15, No. 4, 251-255 (2001)
DOI: 10.1177/026988110101500403
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