정신분열병환자에서 Haloperidol 투여에 따른 치료반응과 혈장 Homovanillic Acid 농도 및 혈장 Haloperid이과 Reduced Haloperidol 농도와의 관계에 대한 연구

Plasma Haloperidol, Reduced Haloperidol and Homovanillic Acid Levels : Their Relationship to Therapeutic Response of Haloperidol in Schizophrenic Patients

In order to develop a more effective therapeutic guidelin es for haloperidol treatment the authors measured plasma haloperidol (H P ), reduced halopferidol (R H ) and homovan illic acid (HVA ) levels in 14 schizophrenic patients and analyzed their relationship to therapeutic response. The plasma homovanillic acid levels were further evaluated to see whether it can be adopted as a predictive biological marker reflecting therapeutic response of haloperidol. The measurement of plasma haloperidol, reduced haloperidol an dHVA levels were carried out with high performance liquid chromatography (HPLC) and the therapeutic reponses were assessed with Brief Psychiatric Rating Scale (BPRS) every week before and during the administration of haloperidol for 5 weeks. The results of this study are as follows. 1) There was no significant changes on the plasma HVA levels after haloperidol administration as a whole. But in high er pHVA group (baseline plasma HVA level>4 .5 ng /ml), the plasma HVA levels were significantly decreased after haloperidol administration, and inlower pHVA group (baseline plasma HVA level< 4 .5 ng /ml)，the plasma HVA levels were significantly increased com pared to baseline plasma HVA levels. 2 ) Total BPRS scores were continuouly and significantly decreased from 1st week to 3rd week after haloperidol administration not only in total subject, but also in higher pHVA group and lower pHVA group. 3) There was significant correlation between baseline plasma HVA levels and clinical improvem entCpercentile improvement) at 3rd week in higher pHVA group. But no significant correlation was found - between baseline plasma HVA levels and clinical improvement in total subject or in lower pHVA group. 4 ) Hyperbolic correlation was observed between plasma haloperidol level and plasma RHlevel (Km = 33 .1lng /ml). 5 ) There were no statistically significant correlations between clinical improvement and plasm a haloperidol level, plasma RH level and RH /HP ratio in any of the total subject higher pHVA group and lower pHVA group. 6) The changes of plasma HVA levels after haloperidol administration were not significantly correlated with plasma haloperidol level, plasma RH level and RH /HP ratio in any of the total subject higher pHVA group and lower pHVA group.