NEUROLEPTIC MONITORING - RELATION BETWEEN ANTIPSYCHOTIC EFFICIENCY AND RADIORECEPTOR ASSAY OF SERUM HALOPERIDOL

Objective: We report preliminary results from use of a radioreceptor a ssay (RRA) to measure serum haloperidol levels and their relation to c linical response and adverse effects in 19 psychotic patients with pos itive symptoms treated with haloperidol. Methods: Blood samples were t aken on Days 7, 14 and 21. Clinical evaluation was based on the PANSS, and UKU scales. The D2 antidopaminergic RRA was used to measure halop eridol serum levels. Results: Our results show a correlation between p sychosis with positive symptoms assessed by positive scores in the PAN SS and the serum drug level measured by RRA concentrations. The observ ed relationship made it possible to establish a therapeutic serum rang e of haloperidol equivalents 15-30 ng/ml(-1). This range contained no ''non-responders''. Analysis of the correlation between each item on t he 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 wee k, however, certain specific symptoms were closely connected to the RR A concentration. Conclusion: From these results, it can be concluded t hat antipsychotic activity can be related to blockade of serum D2 dopa mine receptors. In future would be desirable to monitor neuroleptic tr eatment in this way. The study also showed that the antipsychotic trea tment did not correct any specific component of the psychosis during t he first stage of the treatment but that it did so at later times.