Haloperidol Decanoate 유지치료와 주체외로증상

Haloperidol Decanoate Maintenance Therapy and Extrapyramidal Side Effects

For the purpose of evaluating clinical problems of extrapyramidal side effect(EPS) from haloperidol decanoate, fifty three chronic schizophrenic inpatients were switched abruptly from oral maintenance therapy to haloperidol decanoate and the EPSs were evaluated by the DiMascio Scale for 12 weeks. Haloperidol decanoate was injected every 4 weeks, with dosages of 15 times of oral haloperidol dosages. In the cases of oral antipaychotic medication other than haloperidol, the dosages of oral haloperidol were calculated by Suy’s Conversion Table. Overall incidence of EPS including very mild cases was 68 percent ； parkinsonism, 66 percent •• akathisia, 57 percent: and dystonia, 32 percent. Ninety percent of EPSs appeared within 2 weeks after the first haloperidol decanoate injection. Severity of EPS was mild ; only 4 cases were dropped out because of their EPS. Antiparkinsonian drug was necessary for the management in 60 percent of the sample. All the cases except one could be controlled by the antiparkinsonian drug. After 10 weeks medication, the antiparkinsonian drug was abruptly withdrawn. The EPS reappeared in 83 percent within 2 weeks. The date of first appearance of EPS was 9.0 (± 11.1) days after the first injection. The EPSs were more prevalent in the cases of shorter duration of previous oral antipsychotic medication and in the cases with history of EPS by previous oral medication. Consquently, this study suggests that EPS due to haloperiodol decanoate is not so serious in incidence and severity in comparison with oral antipsychotics. Early abrupt withdrawal of antiparkinsonian drug seems to be undesirable. Careful observation should be done in the cases with EPS history by previous oral antipsychotics and in the fresh cases.