Pretreatment plasma HVA and haloperidol response in acute mania

Citation
Jcy. Chou et al., Pretreatment plasma HVA and haloperidol response in acute mania, J AFFECT D, 59(1), 2000, pp. 55-59
Citations number
9
Categorie Soggetti
Psychiatry,"Neurosciences & Behavoir
Journal title
JOURNAL OF AFFECTIVE DISORDERS
ISSN journal
01650327 → ACNP
Volume
59
Issue
1
Year of publication
2000
Pages
55 - 59
Database
ISI
SICI code
0165-0327(200007)59:1<55:PPHAHR>2.0.ZU;2-R
Abstract
Introduction: Pretreatment plasma homovanillic acid (HVA) levels have been reported to be a correlate of clinical response to typical antipsychotics f or schizophrenic, bipolar manic, and mixed groups of psychotic patients. Bi ological markers of clinical response to antipsychotics could be useful for optimizing drug treatment. Method: Thirty-one consenting acute inpatient s ubjects between ages 19 and 66 years with a DSM-III-R clinical diagnosis of bipolar disorder, manic with psychotic features were entered into this dou ble-blind study and were randomly assigned to receive either haloperidol 25 mg/day or haloperidol 5 mg for the 3-week study. Subjects also received on e of the following concomitant medications: standard lithium, lorazepam 4 m g/day, or placebo. Results: The primary multiple regression analysis, inclu ding all subjects on both haloperidol doses, yielded a significant main eff ect for pretreatment plasma HVA (n = 31, F = 5.7, P = 0.025), indicating th at higher pretreatment plasma HVA was predictive of better clinical respons e. In addition, the interaction between haloperidol dose and pretreatment p lasma HVA was also significantly associated with clinical response (F = 12. 59, P = 0.0015). When the two haloperidol doses were analyzed separately, w e found that pretreatment plasma HVA was only correlated with clinical resp onse 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 gr oup, Limitations: The sample size was small. Results may have been confound ed by prior antipsychotic treatment and concomitant use of lithium or loraz epam. Discussion: These results suggest, that pretreatment plasma HVA could be useful for dosing antipsychotics. Patients with high plasma HVA levels would be good candidates for low-dose treatment because they are more likel y to improve on such a dose, while patients with low plasma HVA levels migh t warrant more rapid dosage escalation. (C) 2000 Elsevier Science B.V. All rights reserved.