title: Olanzapine versus haloperidol in the treatment of schizoaffective disorder. Acute and long-term therapy. A controlled Nordic multicentre study of zuclopenthixol acetate in oil solution, haloperidol and zuclopenthixol in the treatment of acute psychosis A comparison of haloperidol, lithium carbonate and their combination in the treatment of mania. Haloperidol Blood Levels in Acute Mania With Psychosis Psychoactive drugs in mania. A controlled comparison of lithium carbonate, chlorpromazine, and haloperidol. A 12-week, double-blind comparison of olanzapine vs haloperidol in the treatment of acute mania. A double-blind randomized clinical trial of rapid tranquilization with I.M. clonazepam and I.M. haloperidol in agitated psychotic patients with manic symptoms. Acute high-dose parenteral haloperidol treatment of psychosis. Are patients with bipolar affective disorder socially disadvantaged? A comparison with a control group. A Double-Blind, Randomized, Prospective Evaluation of the Efficacy and Safety of Risperidone Versus Haloperidol in the Treatment of Schizoaffective Disorder [Flupenthixol versus haloperidol in acute psychotic episodes]. A randomized comparison of divalproex oral loading versus haloperidol in the initial treatment of acute psychotic mania. Symptomatic predictors of ECT response in medication-nonresponsive manic patients. A multicentre study on the efficacy and safety of individualized dosage of haloperidol (Haldol) in refractory chronic psychotics. Dosage of haloperidol for mania. Acute and continuation risperidone monotherapy in bipolar mania: a 3-week placebo-controlled trial followed by a 9-week double-blind trial of risperidone and haloperidol Lithium combined with carbamazepine or haloperidol in the treatment of mania. Rapid tranquilization: A comparative study of thiothixene and haloperidol Carbamazepine compared to haloperidol in acute mania. Pretreatment plasma HVA and haloperidol response in acute mania. The Safety and Pharmacokinetics of Quetiapine When Coadministered With Haloperidol, Risperidone, or Thioridazine Dose and blood levels of haloperidol in treatment of mania. Olanzapine versus haloperidol in the treatment of acute mania: clinical outcomes, health-related quality of life and work status A double-blind randomised comparison of risperidone and haloperidol in the treatment of behavioural and psychological symptoms in Chinese dementia patients. Risperidone Compared with Both Lithium and Haloperidol in Mania: A Double‐Blind Randomized Controlled Trial Combination of a mood stabilizer with risperidone or haloperidol for treatment of acute mania: a double-blind, placebo-controlled comparison of efficacy and safety.
abstract: BACKGROUND The effectiveness of antipsychotic monotherapy in  schizoaffective disorder  is limited , and further constrained by safety concerns . AIMS We aim ed to compare the efficacy , tolerability and safety profile of the new pharmaceutical , olanzapine , with haloperidol . METHOD Data were assessed from 300 DSM-III-R schizoaffective subjects from a larger double-blind prospect i ve international study . Subjects were r and omly allocated to six weeks of olanzapine ( 5 - 20 mg ) or haloperidol ( 5 - 20 mg ) treatment ; responders were followed for up to one year of double-blind , long-term maintenance therapy . RESULTS Olanzapine-treated patients achieved a statistically significant greater improvement than haloperidol treated patients on overall measures of efficacy , including clinical response . Significantly fewer olanzapine patients left the study early , and fewer adverse events were observed among those receiving olanzapine . During maintenance , olanzapine-treated patients continued to experience additional improvement , with fewer EPS but more weight gain than those on haloperidol . CONCLUSIONS Olanzapine demonstrated substantial advantages over the conventional antipsychotic haloperidol in the management of schizoaffective disorder Zuclopenthixol acetate — a new injectable formulation with a duration of action of 2–3 days — was compared with conventional intramuscular and oral formulations of haloperidol and zuclopenthixol in the initial treatment of acutely disturbed , psychotic patients . The patients were stratified into 3 diagnostic categories : acute psychoses ( 48 patients ) , mania ( 22 patients ) , and exacerbation of chronic psychoses ( 73 patients ) . The patients were rated on the Brief Psychiatric Rating Scale ( BPRS ) , the Bech‐Rafaelsen Mania Rating Scale ( brmas ) ( only manic patients ) and globally on the Clinical Global Impression ( CGI ) . The study was an open , r and omized multicentre trial with a 6‐day treatment period . The zuclopenthixol acetate patients received 1–4 doses , the haloperidol patients 1–26 and the zuclopenthixol patients 1–22 doses . The assessment s on the CGI showed that all 3 treatments caused a clear reduction of the severity of illness scores in all 3 diagnostic categories , with no differences between treatments . The ratings of the acute and chronic psychotic patients on the BPRS also showed significant reductions in scores with no differences between treatments . All 3 treatments caused a rapid remission of symptoms on the BRMAS .  Haloperidol  induced hypokinesia in significantly more patients than zuclopenthixol acetate after 24 h. Later there were no significant differences between treatments . Zuclopenthixol acetate fulfils many desires for an amended neuroleptic formulation for the initial treatment of acutely disturbed psychotic patients Previous investigations of the treatment of mania have result ed in uncertainty about the efficacy of lithium versus a neuroleptic . In addition there have been reports of toxicity with a haloperidol -- lithium combination . In order to determine the comparative efficacy of lithium vs haloperidol vs a combination of haloperidol -- lithium , we studied 21 severely ill manic patients who all met rigorous criteria for bipolar illness and who required in hospital treatment . Subjects were r and omly assigned to 3 groups : ( A ) Lithium plus placebo ( B ) Placebo plus haloperidol and ( C ) Lithium plus haloperidol . The study was conducted in double blind fashion for 3 weeks with the dosages of the medications varied according to clinical response or untoward effects . Subjects on haloperidol and placebo or the haloperidol -- lithium combination were significantly improved after 7 days in comparison to the lithium-treated group . Groups B and C did not differ from each other , either in degree of improvement or in side effects . Inspite of the relatively small sample size the results suggest ( 1 ) that haloperidol is superior to lithium for treating severely ill acute mania and ( 2 ) that while a haloperidol -- lithium combination does not result in a significant increase in side effects , it is not superior to haloperidol alone In this study , the authors examined the relationship between steady-state haloperidol  blood levels and clinical response in patients with acute psychotic mania . Fifty-four in patients with acute mania were r and omly assigned to receive either haloperidol 25 mg/day or haloperidol 5 mg/day . Each subject also received a concomitant medication : lorazepam 4 mg/day , lithium , or placebo . The relationship between steady-state  haloperidol blood levels and clinical improvement was studied using analysis of covariance . There was wide interindividual variation in the  haloperidol blood level – dose ratio . Haloperidol blood levels ( log-transformed ) were found to significantly correlate with clinical response in acute mania . Low-dose haloperidol with concomitant lithium may produce an optimal response in acute mania .  Haloperidol blood levels may be clinical ly useful in identifying patients who are nonresponsive because of low drug levels and , hence , in enhancing optimal haloperidol dosing for acute mania with psychosis Lithium carbonate , haloperidol , and chlorpromazine hydrochloride were compared in a double-blind controlled study with severely ill hospitalized manics .  Lithium carbonate and haloperidol produced a highly significant improvement of manic symptoms without sedation . Although producing considerable sedation , chlorpromazine did little to alter the underlying mania qualitatively . Qualitative differences between lithium carbonate and haloperidol indicate that , while haloperidol has a more dramatically rapid impact on behavior-motor activity , lithium carbonate acted more evenly on the entire manic picture , with total normalization realized during active treatment . The majority of lithium carbonate-treated patients met discharge criteria at study termination , but not the patients receiving either neuroleptic drug . The rating scales are not sensitive enough to monitor manic psychopathology ; this accounts for the lack of statistically significant differences among drug groups at treatment termination , despite the widely disparate discharge rates BACKGROUND This r and omized controlled trial compares the efficacy and safety of olanzapine vs haloperidol , as well as the quality of life of patients taking these drugs , in patients with bipolar mania . METHODS The design consisted of 2 successive , 6-week , double-blind periods and compared flexible dosing of olanzapine ( 5 - 20 mg/d , n = 234 ) with haloperidol ( 3 - 15 mg/d , n = 219 ) . RESULTS Rates of remission ( Young-Mania Rating Scale score of < or = 12 and 21-item Hamilton Rating Scale for Depression score of < or = 8 at week 6 ) were similar for  olanzapine- and haloperidol-treated patients ( 52.1 % vs 46.1 % , respectively ; P = .15 ) . For the subgroup of patients whose index episode did not include psychotic features , rates of remission were significantly greater for the olanzapine group compared with the haloperidol group ( 56.7 % vs 41.6 % , P = .04 ) . Relapse into an affective episode ( mania and /or depression ) occurred in 13.1 % and 14.8 % of olanzapine- and haloperidol-treated patients , respectively ( P = .56 ) . Switch to depression occurred significantly more rapidly with haloperidol than with olanzapine when using survival analysis techniques ( P = .04 ) , and significantly more haloperidol-treated patients experienced worsening of extrapyramidal symptoms , as indicated by several measures . Weight gain was significantly greater in the olanzapine group compared with the haloperidol group ( 2.82 vs 0.02 kg , P<.001 ) . The olanzapine group had significant improvement in quality of life on several dimensions compared with the haloperidol group . CONCLUSIONS These data suggest that olanzapine does not differ from haloperidol in achieving overall remission of bipolar mania . However , haloperidol carries a higher rate of extrapyramidal symptoms , whereas olanzapine is associated with weight gain This double-blind clinical trial studied 16 acutely agitated psychotic patients with manic or manic-like symptoms who needed rapid tranquilization and were therefore on maintenance treatment . They were r and omized to receive intramuscular preparations of clonazepam ( 1 to 2 mg ) or haloperidol ( 5 to 10 mg ) at 0 , 0.5 , and 1.0 hours . Both medications produced significant reduction of manic symptoms within two hours of initial treatment ; however , haloperidol produced beneficial results more rapidly than clonazepam . All patients completed the study , with the exception of one haloperidol-treated patient who developed severe parkinsonism . It was concluded that I.M. clonazepam is an effective , safe , but slower-acting alternative to I.M. haloperidol in the treatment of agitated psychiatric patients in need of rapid tranquilization After 2 days of drug-free observation , 20 newly admitted psychotic patients received 20 - 35 mg of haloperidol intravenously and 20 patients received 30 - 40 mg of diazepam intravenously . Posttreatment ratings at 4 and 24 hours with the Brief Psychiatric Rating Scale and the Clinical Global Impressions revealed significant improvement in both groups but no significant differences between the two treatments BACKGROUND Bipolar affective disorder ( BPAD ) has considerable implication s for personal and social functioning . However a tendency to be over-represented in high socio-economic classes has been reported in earlier studies , suggesting that social disadvantage accompanying the illness is not severe . In addition , an association between affective disorders in general and increased residential mobility has been suggested , but it is unclear if such an association exists with BPAD . OBJECTIVES ( 1 ) To investigate the suggestion made in previous studies that patients with bipolar disorder are advantaged socially . ( 2 ) To test the hypothesis that patients with bipolar disorder show greater residential mobility compared with other patients with psychiatric disorders . METHODS Ninety patients with DSM IV diagnosis of bipolar disorder admitted to the acute in-patient unit of a public-financed district psychiatric service in Dublin were compared with a control group of 91 r and omly selected patients with other psychiatric diagnoses , excluding schizophrenia .  Socio-economic , educational and employment ratings were compared , and also  duration of illness , frequency of admission and residential mobility .  The data were collected retrospectively from case notes and through semistructured interviews with patients or their relatives . The bipolar group was compared with the control group and to the unipolar depression subgroup . RESULTS The bipolar and control groups were found to have similar demographic and socio-economic features , although the bipolar group had more years of education compared with the whole control group but not when compared with the unipolar depression group . The bipolar group showed longer duration of psychiatric disorder , more frequent hospital admissions and more frequent residential moves since the onset of the illness . CONCLUSION Bipolar patients requiring in-patient care in this service experience severe disruption to their lives over prolonged periods The relative efficacy and safety of risperidone versus haloperidol in the treatment of schizoaffective disorder was studied . Sixty-two patients ( 29 depressed type ; 33 bipolar type ) entered a three-site , r and omized , double-blind , 6-week trial of risperidone ( up to 10 mg/day ) or haloperidol ( up to 20 mg/day ) . Trained raters assessed baseline , weekly , and end-of- study levels of psychopathology with the Positive and Negative Syndrome Scale ( PANSS ) , the 24-item Hamilton Rating Scale for Depression ( HAM-D-24 ) and the Clinician-Administered Rating Scale for Mania ( CARS-M ) . The authors were unable to statistically distinguish between risperidone and haloperidol in the amelioration of psychotic and manic symptoms . In addition , there was no difference in worsening of mania between the two agents in either subgroup ( i.e. , depressed or bipolar subgroups ) . For the total PANSS , risperidone produced a mean decrease of 16 points from baseline compared with a 14-point decrease with haloperidol . For the total CARS-M scale , risperidone and haloperidol produced mean change scores of 5 and 8 points , respectively , and for the CARS-M Mania subscale , 3 and 7 points , respectively . Additionally , risperidone produced a mean decrease of 13 points from the baseline 24-item HAM-D , compared with an 8-point decrease with haloperidol . In those patients who had more severe depressive symptoms ( i.e. , HAM-D baseline score > 20 ) , risperidone produced at least a 50 % mean improvement in 12 ( 75 % ) of 16 patients in comparison to 8 ( 38 % ) of 21 patients receiving haloperidol . Haloperidol produced significantly more extrapyramidal side effects and result ed in more dropouts caused by any side effect . There was no difference between risperidone and haloperidol in reducing both psychotic and manic symptoms in this group of patients with schizoaffective disorder .  Risperidone did not demonstrate a propensity to precipitate mania and was better tolerated than haloperidol . In those subjects with higher baseline HAM-D scores ( i.e. , > 20 ) , risperidone produced a greater improvement in depressive symptoms than haloperidol The aim of this study is to evaluate the activity of flupentixol oral high concentration and to define the profile of the drug according to the administered dose . The trial includes 40 acute patients ( 21 schizophrenics , 13 manic patients and 6 other psychotics ) . The study was open , but the patients were treated at r and om either by haloperidol or by flupentixol . Both substances showed a strong antipsychotic and antimanic effect . The differences according to the administered doses were : a quicker onset of action for flupentixol in schizophrenic patients ; a more pronounced activity of flupentixol in the same patients , as far as anxiety , depressive tendencies and defect symptoms are concerned . Extrapyramidal side effects are the most common ones amongst the two drugs BACKGROUND Uncontrolled evidence suggests that divalproex administered via the oral loading strategy of 20 mg/kg/day may produce clinical ly significant antimanic response within 3 days of treatment in some patients . We conducted a prospect i ve study to compare the antimanic response of divalproex oral loading with that of haloperidol in the initial treatment of acute psychotic mania . METHOD After a < or = 1-day screening period , 36 consecutive hospitalized patients with bipolar disorder , manic or mixed phase and with psychotic features , were r and omly assigned to receive either divalproex 20 mg/kg/day or haloperidol 0.2 mg/kg/day for 6 full days , without other psychotropic agents except lorazepam up to 4 mg/day for management of agitation . Serum valproate concentrations were measured after 1 day of treatment . Response was measured daily by a blind rater using the Young Mania Rating Scale and the Scale for Assessment of Positive Symptoms . RESULTS Divalproex oral loading and haloperidol were equally effective in acutely reducing manic and psychotic symptoms . The greatest rate of improvement for both drug regimens occurred over the first 3 full days of treatment . Side effects were infrequent and minor for both treatments , except for extrapyramidal side effects which were significantly more common with haloperidol . CONCLUSION Divalproex oral loading may produce rapid onset of antimanic and antipsychotic response comparable to that of haloperidol and with minimal side effects in the initial treatment of acute psychotic mania in a subset of bipolar patients BACKGROUND Relations between pretreatment symptom ratings and ECT outcome were examined in acute manic patients admitted at a state psychiatric center who were nonresponsive to medication . METHOD One or 2 days after undergoing pretreatment clinical ratings , patients were r and omly assigned to intensive pharmacotherapy , right unilateral ECT , left unilateral ECT , or bilateral ECT .  Patients who failed to respond to any of the first three treatment conditions were assigned to crossover bilateral ECT .  Patients who failed to respond to a primary treatment condition other than bilateral ECT but refused crossover bilateral ECT  and those in whom ECT was terminated due to an organic brain syndrome were not considered for this study . No psychotropic drugs were prescribed for 4 - 7 days before , or during , the course of ECT . Of the 24 patients who entered the study , 18 patients completed the protocol . Based on independent clinical assessment s by two research psychiatrists , a favorable treatment response was defined as a complete recovery from manic episode that was sustained for 1 week during which no psychotropic medications were prescribed . RESULTS ECT nonresponders were significantly more angry , irritable , and suspicious than ECT responders . Severity of mania and depression ratings at baseline were not related to ECT response . CONCLUSION Symptoms associated with poor response to ECT may overlap with those that have been reported to predict nonresponse to treatment with lithium . Our evidence also may support the view that differential symptom patterns may predict treatment outcomes to ECT and carbamazepine , respectively , in manic patients who do not respond to treatment with lithium or neuroleptics This study was carried out on 38 chronic refractory psychotic patients who received partial multimodal treatment with individually adapted doses of Haldol .  The study was based on : --Howard 's experiences : more than half of his chronic psychotic patients were able to leave the State Hospital because of the multimodal treatment with high individualized doses of Haldol ; -Paquay and Tanghe 's experiences : one-fourth to more than one-half of their chronic refractory patients showed remarkable improvement with a partial multimodal treatment . This study shows that improvement is obtained in more than 2 out of 3 cases , thus proving that the best results are obtained when an adequate selection of the patients is made . As side-effects , above all , the extrapyramidal symptoms are possible . However , their frequency and intensity are not higher than those provoked by other incisive neuroleptics or conventional doses of Haldol . Special attention should be given to any pseudodepression or neurovegetative reactions . The individualization of the doses should be carefully done BACKGROUND We compared three doses of a neuroleptic as a treatment for mania . METHOD Forty-seven newly admitted in- patients with mania were r and omised to receive 10 , 30 , or 80 mg a day of oral haloperidol , under double-blind conditions for up to six weeks . All subjects received prophylactic benztropine . RESULTS Repeated- measures analysis of variance and survival analysis showed no difference in outcome by the different doses . Excluding drop-outs ( 38 % ) , most of whom left the study during the first two weeks , 72 % of the subjects responded . Side-effects were minimal ; there were no differences among the three doses . Non-responders received more adjunctive lorazepam than responders . CONCLUSIONS The limited data suggest that more than 10 mg a day of haloperidol offers no advantage in mania In a r and omized , double-blind trial , patients with acute bipolar mania received 1 - 6 mg/day of risperidone , 2 - 12 mg/day of haloperidol , or placebo for 3 weeks , followed by double-blind risperidone or haloperidol for 9 weeks . Of 438 patients , 154 were r and omized to risperidone , 144 to haloperidol , and 140 to placebo .  The mean+/-S.D. modal doses were 4.2+/-1.7 mg/day of risperidone and 8.0+/-3.6 mg/day of haloperidol during the initial 3-week phase and 4.1+/-1.8 and 7.4+/-3.7 mg/day during the 12-week period . At week 3 , mean Young Mania Rating Scale ( YMRS ) score reductions from baseline were significantly greater in patients receiving risperidone than placebo ( p<0.001 ) . Differences between risperidone and haloperidol on this efficacy measure were not significant . Further reductions in YMRS scores were seen in patients receiving risperidone or haloperidol during the subsequent 9 weeks . No unexpected adverse events were reported . Extrapyramidal disorder and hyperkinesias , the most commonly reported adverse events with antipsychotic use , occurred less frequently with risperidone than haloperidol . We conclude that risperidone monotherapy was an effective and well-tolerated treatment for bipolar mania and that efficacy was maintained over the long term Hospitalized manic patients were withdrawn from psychoactive medications for 2 weeks after which they were r and omized to double-blind treatment with carbamazepine plus lithium [ CBZ-Li ] or haloperidol plus lithium [ HAL-Li ] with benztropine . Unit dosages of Li 300 mg , CBZ 200 mg and HAL 2 mg were titrated to therapeutic plasma levels and maintained for 8 weeks . No rescue medications were permitted after 3 weeks . St and ard ratings of psychopathology and side effects were accomplished weekly . Sixty patients entered the study but only 33 remained for r and omization after drug washout . By 8 weeks both groups were improved from baseline without statistically reliable differences between them . However HAL-Li patients had more extrapyramidal side effects that were major reasons for dropout , whereas CBZ-Li patients were more often noncompliant and initially required more rescue medications . We conclude that either combination treatment can be beneficial but CBZ-Li has the advantage because of fewer neurologic side effects In a double-blind comparative clinical study , both thiothixene and haloperidol were found to be effective agents for rapid tranquilization of manic and schizophrenic patients . While no statistically significant difference in any of the psychopathological areas which may create a psychiatric emergency was found , results of this study provide further substantiation of the notion that thiothixene has favorable effects on anergia In a double-blind , between-patient clinical trial carbamazepine ( CBZ ) ( n = 8) was compared to haloperidol ( HP ) ( n = 9 ) in patients presenting with mania ( DSM III ) . Seven patients on HP and 2 on CBZ  failed to complete 4 weeks treatment . In 4 of the  HP  group this was because of extrapyramidal side-effects ( EPS ) . Two patients on CBZ and 2 on HP were withdrawn because of lack of efficacy . Statistically significant clinical improvement was seen in both groups within the first 2 weeks of treatment with HP acting more quickly . In addition to EPS which occurred in HP patients , drowsiness was experienced in 4 on CBZ and 3 on HP , and gastrointestinal symptoms in 3 on CBZ . No serious haematological changes , nor abnormalities in clinical chemistry occurred in either group . We conclude that CBZ appears to be a potentially useful drug in the treatment of acute mania INTRODUCTION Pretreatment plasma homovanillic acid ( HVA ) levels have been reported to be a correlate of clinical response to typical antipsychotics for schizophrenic , bipolar manic , and mixed groups of psychotic patients . Biological markers of clinical response to antipsychotics could be useful for optimizing drug treatment . METHOD Thirty-one consenting acute inpatient subjects between ages 19 and 66 years with a DSM-III-R clinical diagnosis of bipolar disorder , manic with psychotic features were entered into this double-blind study and were r and omly assigned to receive either haloperidol 25 mg/day or haloperidol 5 mg for the 3-week study . Subjects also received one of the following concomitant medications : st and ard lithium , lorazepam 4 mg/day , or placebo . RESULTS The primary multiple regression analysis , including all subjects on both haloperidol doses , yielded a significant main effect for pretreatment plasma HVA ( n=31 , F=5.7 , P=0.025 ) , indicating that higher pretreatment plasma HVA was predictive of better clinical response . In addition , the interaction between haloperidol dose and pretreatment plasma HVA was also significantly associated with clinical response ( F=12.59 , P=0.0015 ) . When the two haloperidol doses were analyzed separately , we found that pretreatment plasma HVA was only correlated with clinical response in the low haloperidol 5 mg/day group ( n=18 , F=11.73 , P=0.0038 ) and was unrelated to clinical response to the high haloperidol 25 mg/day group . LIMITATIONS The sample size was small . Results may have been confounded by prior antipsychotic treatment and concomitant use of lithium or lorazepam . DISCUSSION These results suggest that pretreatment plasma HVA could be useful for dosing antipsychotics . Patients with high plasma HVA levels would be good c and i date s for low-dose treatment because they are more likely to improve on such a dose , while patients with low plasma HVA levels might warrant more rapid dosage escalation The effects of haloperidol , risperidone , and thioridazine on the pharmacokinetics and side-effect profile of quetiapine were investigated in 36 patients with schizophrenia , schizoaffective disorder , or bipolar disorder in a single-center , two-period , multiple-dose , open-label , r and omized trial . Over a one-to two-week period , quetiapine doses were escalated to 300 mg twice daily ( bid ) . Patients were then treated for at least 7 days at the target quetiapine dose and subsequently entered into the combination therapy period , receiving haloperidol ( 7.5 mg , bid ) , risperidone ( 3 mg , bid ) , or thioridazine ( 200 mg , bid ) for 8.5 days ( after 3 days of dose escalation ) . Key assessment s included the pharmacokinetics of quetiapine at steady state ( area under the curve within a dosing interval [ AUCtSS ] , maximum [ CmaxSS ] , and minimum [ CminSS ] observed plasma concentrations , and oral clearance [ Cl/f ] ) , as well as the UKU Side Effect Rating Scale scores and safety evaluations . Neither risperidone nor haloperidol had significant effects on quetiapine pharmacokinetics . However , thioridazine produced statistically significant changes , decreasing the least squares means values of the AUCtSS , CmaxSS , and CminSS by 40 % , 47 % , and 31 % , respectively , and increasing Cl/f by 68 % . Increases in the following adverse events were noted during coadministration : somnolence  ( risperidone )  , insomnia and dry mouth ( all three coadministered therapies ) , and dizziness  ( thioridazine ) . UKU side effect items that became worse in ≥ 25 % of patients during each coadministration period included sedation and increased sleep duration . Results of laboratory tests , electrocardiograms , and vital sign measurements revealed few clinical ly important changes . Clinical stability can be maintained with good tolerability during the transition from quetiapine monotherapy to periods of coadministration with haloperidol , risperidone , or thioridazine . Coadministration of either haloperidol or risperidone did not have any important effects on the steady-state pharmacokinetics of quetiapine . Thioridazine significantly increased the oral clearance of quetiapine . Increased doses of quetiapine may be necessary to control psychotic symptoms when thioridazine is coadministered with quetiapine Three doses of haloperidol , 10 mg/day , 30 mg/day , and 80 mg/day , were compared in 47 newly admitted manic patients . There was no difference in outcome within 6 weeks among the three doses . Four blood levels of plasma and red blood cell ( RBC )  haloperidol and reduced haloperidol showed no linear or curvilinear relationships to clinical response We aim ed to compare clinical outcomes , health-related quality of life ( HRQOL ) and work status associated with olanzapine and haloperidol treatment in patients with bipolar disorder . This double-blind , r and omized controlled trial , comparing flexible dosing of olanzapine ( 5–20 mg/day , n = 234 ) to haloperidol ( 3–15 mg/day , n = 219 ) , consisted of a 6-week acute phase , followed by a 6-week continuation phase . Symptomatic remission rates were similar for olanzapine- and haloperidol-treated patients at weeks 6 and 12 . At week 6 , significant changes in five dimensions of the Medical Outcomes Study 36-Item Short Form Health Survey ( SF-36 ) [ general health ( P = 0.010 ) , physical functioning ( P < 0.001 ) , role limitations due to physical problems ( P < 0.001 ) , social functioning ( P < 0.05 ) and vitality ( P < 0.01 ) ] and the SF-36 physical components summary score were found in favour of olanzapine compared to haloperidol . At week 12 , olanzapine treatment maintained the significantly favourable HRQOL changes . At the end of week 12 , patients on olanzapine showed significantly greater improvement than haloperidol  in work activities impairment and household activities impairment scores on the Streamlined Longitudinal Interview Clinical Evaluation from the Longitudinal Interval Follow-up Evaluation ( SLICE/LIFE ) activities impairment scores . Subgroup analyses revealed that olanzapine treatment significantly increased a proportion of employed patients and their weekly paid working hours . In conclusion , compared to haloperidol , olanzapine treatment was comparably effective in the remission of bipolar mania and significantly improved HRQOL and work status in patients with bipolar I disorder BACKGROUND Behavioural and psychological symptoms ( BPSD ) are common during the course of dementia and present severe problems to patients and their caregivers . OBJECTIVES To assess the therapeutic efficacy and safety of haloperidol and risperidone in treating BPSD in Chinese dementia patients . METHODS A 12-week double-blind r and omised comparison of haloperidol and risperidone treatments was conducted in 58 patients with DSM-IV diagnosis of dementia of Alzheimer 's type or vascular dementia . They were r and omly assigned to receive flexible doses ( 0.5 to 2 mg/day ) of haloperidol or risperidone . Clinical response was evaluated using the Cohen-Mansfield Agitation Inventory ( CMAI ) , the Behavioral Pathology in Alzheimer 's Disease Rating Scale ( BEHAVE-AD ) , Simpson-Angus Scale , Functional Assessment Staging and Cantonese version of the Mini-Mental State Examination . RESULTS The mean doses at the last week were 0.90 mg/day of haloperidol and 0.85 mg/day of risperidone . Both haloperidol and risperidone significantly reduced the severity of BPSD ( scores on CMAI and BEHAVE-AD ) , with no significant between-group differences . Haloperidol-treated patients showed a worsening on Simpson-Angus scale while there was no significant change in this measure in risperidone-treated patients . CONCLUSIONS Low-dose haloperidol and risperidone were well tolerated and associated with reductions in the severity and frequency of behavioural symptoms in subjects with dementia .  Risperidone may have a more favourable risk-benefit profile in view of its lower propensity to induce extrapyramidal symptoms Case reports and studies of other neuroleptics suggest the efficacy of risperidone in the treatment of mania . Forty-five in patients with DSM-IV mania were studied in a 28-day r and omized , controlled , double-blind trial of either 6 mg daily of risperidone , 10 mg daily of haloperidol , or 800 to 1200 mg daily of lithium . The patients in all three groups showed a similar improvement on the total score for all rating scales at day 28 ( Brief Psychiatric rating scale :  lithium 9.1 , haloperidol 4.9 , risperidone 6.5 , F = 1.01 , df = 2 , p = 0.37 ; Mania rating scale :  lithium 15.7 , haloperidol 10.2 , risperidone 12.4 , F = 1.07 , df = 2 , p = = 0.35 [ analysis of variance ] ) . The Global Assessment of Functioning and Clinical Global Impression data showed a similar pattern of improvement . This study suggests that risperidone is of equivalent efficacy to lithium and haloperidol in the management of acute mania . The extrapyramidal side effects of risperidone and haloperidol were not significantly different OBJECTIVE The study assessed the efficacy and safety of risperidone as an adjunctive agent to mood stabilizers in the treatment of acute mania .  METHOD This 3-week r and omized , double-blind , placebo-controlled study included 156 bipolar disorder patients with a current manic or mixed episode who received a mood stabilizer ( lithium or divalproex ) and placebo , risperidone , or haloperidol .  The primary efficacy measure was the Young Mania Rating Scale . Other assessment s used the Brief Psychiatric Rating Scale , the Clinical Global Impression scale , and safety measures . RESULTS The trial was discontinued by 25 ( 49 % ) of the 51 placebo group patients , 18 ( 35 % ) of the 52 risperidone group patients , and 28 ( 53 % ) of the 53 haloperidol group patients . Mean modal doses were 3.8 mg/day ( SD=1.8 ) of risperidone and 6.2 mg/day ( SD=2.9 ) of haloperidol . Significantly greater reductions in Young Mania Rating Scale scores at endpoint and over time were seen in the risperidone group and in the haloperidol group , compared with the placebo group . Young Mania Rating Scale total scores improved with risperidone and with haloperidol both in patients with psychotic features and in those without psychotic features at baseline . Extrapyramidal Symptom Rating Scale total scores at endpoint were significantly higher in the haloperidol patients than in the placebo patients . Antiparkinsonian medications were received by 8 % , 17 % , and 38 % of patients in the placebo , risperidone , and haloperidol groups , respectively . CONCLUSIONS Risperidone plus a mood stabilizer was more efficacious than a mood stabilizer alone , and as efficacious as haloperidol plus a mood stabilizer , for the rapid control of manic symptoms and was well tolerated
target: There is some evidence that haloperidol is an effective treatment for  acute mania .
  From the limited data available , there was no difference in overall efficacy of treatment between haloperidol and olanzapine or risperidone .
  Some evidence suggests that haloperidol could be less effective than aripiprazole .
background: BACKGROUND The main objectives in treating mania are to control dangerous behaviour , reduce suicide , produce appropriate acute sedation and shorten the episode of mood disturbance .
  Among different drugs , haloperidol has for many years been used in treating psychotic patients , but it has a troublesome side effect profile .
  OBJECTIVES To assess the effects of haloperidol for the treatment of mania in comparison with placebo or other active drugs , either as monotherapy or add-on treatment .