Haloperidol plasma levels and clinical response: A therapeutic window relationship

Theodore Van Putten, Stephen R. Marder, Jim Mintz, Russell E. Poland

Research output: Contribution to journalArticlepeer-review

124 Scopus citations


Objective: The purpose of the study was to assess the relationship between plasma haloperidol and clinical response. Method: Sixty-nine newly admitted drug-free schizophrenic men were randomly assigned to receive haloperidol, 5, 10, or 20 mg daily for 4 weeks, and clinical response was measured at the end of the fixed-dose period. Haloperidol was assayed by a sensitive and specific radioimmunoassay. Results: The authors found a curvilinear relationship between clinical response and plasma haloperidol during fixed-dose treatment, with an apparent optimum between 5 and 12 ng/ml. When plasma levels above 12 ng/ml were lowered to the 5-12 ng/ml range, all patients improved to varying degrees and no patient deteriorated. When plasma levels of nonresponders within this therapeutic window were raised above 12 ng/ml (as in routine practice), they, on balance, deteriorated in that they became more dysphoric. With the 20-mg dose, half the patients had plasma levels above 12 ng/ml. Conclusions: In this sample of newly admitted schizophrenic men, optimal clinical response occurred with a plasma haloperidol range of 5-12 ng/ml.

Original languageEnglish (US)
Pages (from-to)500-505
Number of pages6
JournalAmerican Journal of Psychiatry
Issue number4
StatePublished - 1992
Externally publishedYes

ASJC Scopus subject areas

  • Psychiatry and Mental health


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