Haloperidole serum concentrations in daily child and adolescent psychiatric practice

The highly potent antipsychotic haloperidole is used as third-line treatment for childhood schizophrenia, Tourette's syndrome as well as severe behavioral symptoms in children and adolescents with autism spectrum disorders or mental retardation. Aim of the study was to investigate the relationship between haloperidole dose and serum concentration as well as to generate information about a possible age-specific therapeutic reference range (TRR) in pediatric patients.

Steady state through serum concentrations of haloperidole were measured in pediatric patients in daily clinical practice as part of a routine drug monitoring service. Patient characteristics, doses, and therapeutic outcomes were assessed by standardized measures.

39 patients (64% male, mean age 15.6 years), mainly diagnosed with paranoid schizophrenia were included. A positive correlation between haloperidole daily dose and concentration was found (r_s= 0.37, p= 0.02). Using a rough estimation-method considering only responders to drug therapy a transdiagnostic TRR for minors of 1.9 – 6 ng/ml was calculated (comparable to the current suggested TRR of adults 1–5 ng/ml).

Our preliminary results may contribute to define a TRR of haloperidole in adolescents and support to further establish TDM in child and adolescent psychiatry.

Publication History

Article published online:
12 March 2024