The blood levels of the neurotrophic drug haloperidol (HP) and its pyridinium metabolite, HPP+, have been analyzed by liquid chromatography/electrospray ionization-mass spectrometry in 10 schizophrenic patients treated with HP, without carbamazepine (HP, oral daily dose of 0.3–0.5 mg/kg body weight for more than 1 year, females, aged 41 ± 8.5 years). There was a significant difference (t-test, d.f. = 8, p (t₀ = 7.2) <0.005) in the blood HPP+ level between the 5 patients with (18.5 ± 6.4 ng/ml) and the 5 without (6.3 ± 2.4 ng/ml) severe side effects such as drug-induced parkinsonism (Extrapyramidal Symptom Rating Scale (ESRS) parkinsonism severity scores 2.8 ± 1.5 and 1.8 ± 1.1, respectively). Moreover, it is suggested that vitamin E may be effective for drug-induced parkinsonism through a change in the blood HPP+ level. It is necessary to investigate the HPP+ metabolism in psychiatric patients to avoid severe side effects such as drug-induced parkinsonism and cardiac functional disorders.

Keywords:
HPP, Haloperidol, Vitamin E
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© 2001 S. Karger AG, Basel
2001
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