Haloperidol versus placebo for schizophrenia.


BACKGROUND:Haloperidol was developed in the late 1950s for use in the field of analgesia. Research subsequently demonstrated effects on hallucinations, delusions, aggressiveness, impulsiveness and states of excitement and led to the introduction of haloperidol as an antipsychotic. OBJECTIVES:To evaluate the clinical effects of haloperidol for the management of schizophrenia and other similar serious mental illnesses compared to placebo. SEARCH STRATEGY:Electronic searches of Biological Abstracts (1985-1998), CINAHL (1982-1998), The Cochrane Library (1998, Issue 4), The Cochrane Schizophrenia Group's Register (December 2000), EMBASE (1980-1998), MEDLINE (1966-1998), PsycLIT (1974-1998), and SCISEARCH (January 1974-December 1998) were undertaken. References of all identified studies were searched for further trial citations. Authors of trials and pharmaceutical companies were contacted for further information and archive material. SELECTION CRITERIA:All relevant randomised controlled trials comparing use of haloperidol (any dose) with placebo for those with schizophrenia or other similar serious, non-affective psychotic illnesses (however diagnosed). The main outcomes of interest were death, loss to follow up, clinical and social response, relapse and severity of adverse effects. DATA COLLECTION AND ANALYSIS:Reviewers evaluated data independently and analysed on an intention-to-treat basis, assuming that people who left the study early, or were lost to follow up, had no improvement. Where possible and appropriate, dichotomous data were analysed using relative risk (RR) and their 95% confidence intervals (CI) calculated. If appropriate, the number needed to treat (NNT) or number needed to harm (NNH) was estimated. For continuous data, weighted mean differences were calculated. Continuous data were excluded if loss to follow up was greater than 50%. All data were inspected for heterogeneity. MAIN RESULTS:Seventy-four trials were identified but only 20 included. More people allocated to haloperidol improved in the first six weeks of treatment than those given placebo (three trials, n=159, RR failing to produce a marked improvement 0.44 CI 0.3 to 0.6, NNT 3 CI 2 to 5). A further eight trials (n=313) also found a difference favouring haloperidol across the 6-24 week period (RR no marked global improvement 0.68 CI 0.6 to 0.8 NNT 3 CI 2.5 to 5) but this may be an overestimate of effect as small negative studies were not identified. About half of those entering studies failed to complete the short trials, although, at 0-6 weeks, 10 studies found a difference that favoured haloperidol (n=686, RR 0.82 CI 0.7 to 0.95, NNT 8 CI 5 to 17). Limited adverse effect data do, nevertheless, support the clinical impression that haloperidol is a potent cause of movement disorders, at least in the short term. Haloperidol promotes acute dystonia (three trials, n=135, RR 4.7 CI 1.7 to 44, NNH 5 CI 3 to 9 - not assuming those who left early from placebo suffered dystonis), akathisia (three trials, n=129, RR 6.5 CI 1.5 to 28, NNH 6 CI 4 to 14) and parkinsonism (four trials, n=165, RR 8.9 CI 2.6 to 31, NNH 3 CI 2 to 5). REVIEWER'S CONCLUSIONS:Haloperidol is a potent antipsychotic drug but with a high propensity to cause adverse effects. Given no choice of drug, use of haloperidol to counter the damaging and potentially dangerous consequences of untreated schizophrenia is justified. If a choice of drug is available, however, people with schizophrenia and clinicians may wish to start another antipsychotic with less likelihood of causing parkinsonism, akathisia and acute dystonias. For countries where haloperidol is not widely used, it should not be a control drug of choice for randomised trials of new antipsychotics.


Joy CB,Adams CE,Lawrie SM





Has Abstract


2001-01-01 00:00:00










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    abstract:BACKGROUND:Flexible working conditions are increasingly popular in developed countries but the effects on employee health and wellbeing are largely unknown. OBJECTIVES:To evaluate the effects (benefits and harms) of flexible working interventions on the physical, mental and general health and wellbeing of employees an...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Joyce K,Pabayo R,Critchley JA,Bambra C

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    abstract:BACKGROUND:Decreased concentration of nitric oxide has been proposed as one of the possible cellular mechanisms of necrotising enterocolitis (NEC). Arginine can act as a substrate for production of nitric oxide in the tissues, and arginine supplementation may help to prevent NEC. OBJECTIVES:To examine the effect of ar...

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    authors: Shah PS,Shah VS,Kelly LE

    更新日期:2017-04-11 00:00:00

  • Decompressive craniectomy for the treatment of high intracranial pressure in closed traumatic brain injury.

    abstract:BACKGROUND:High intracranial pressure (ICP) is the most frequent cause of death and disability after severe traumatic brain injury (TBI). It is usually treated with general maneuvers (normothermia, sedation, etc.) and a set of first-line therapeutic measures (moderate hypocapnia, mannitol, etc.). When these measures fa...

    journal_title:The Cochrane database of systematic reviews

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    authors: Sahuquillo J,Dennis JA

    更新日期:2019-12-31 00:00:00

  • Print-based self-help interventions for smoking cessation.

    abstract:BACKGROUND:Many smokers give up smoking on their own, but materials that provide a structured programme for smokers to follow may increase the number who quit successfully. OBJECTIVES:The aims of this review were to determine the effectiveness of different forms of print-based self-help materials that provide a struct...

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    authors: Livingstone-Banks J,Ordóñez-Mena JM,Hartmann-Boyce J

    更新日期:2019-01-09 00:00:00

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    abstract:BACKGROUND:Previous systematic reviews and meta-analyses consistently show the positive effect of exercise-based rehabilitation for heart failure (HF) on exercise capacity; however, the direction and magnitude of effects on health-related quality of life, mortality and hospital admissions in HF remain less certain. Thi...

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    更新日期:2014-04-27 00:00:00

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    abstract:BACKGROUND:Auditory integration therapy was developed as a technique for improving abnormal sound sensitivity in individuals with behavioural disorders including autism spectrum disorders. Other sound therapies bearing similarities to auditory integration therapy include the Tomatis Method and Samonas Sound Therapy. O...

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    更新日期:2011-12-07 00:00:00

  • Melatonin for non-respiratory sleep disorders in visually impaired children.

    abstract:BACKGROUND:Exogenous melatonin helps in regulating the circadian rhythm and is widely used for the management of sleep disorders in visually impaired children. OBJECTIVES:The aim of the review was to assess melatonin therapy for treatment of non-respiratory sleep disorders in visually impaired children, with regard to...

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  • Second or third additional chemotherapy drug for non-small cell lung cancer in patients with advanced disease.

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    authors: Delbaldo C,Michiels S,Rolland E,Syz N,Soria JC,Le Chevalier T,Pignon JP

    更新日期:2007-10-17 00:00:00

  • An overview of systematic reviews on mental health promotion, prevention, and treatment of common mental disorders for refugees, asylum seekers, and internally displaced persons.

    abstract:BACKGROUND:Migrants who have been forced to leave their home, such as refugees, asylum seekers, and internally displaced persons (IDP), are likely to experience stressors which may lead to mental health problems. The efficacy of interventions for mental health promotion, prevention, and treatment may differ in this pop...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章


    authors: Uphoff E,Robertson L,Cabieses B,Villalón FJ,Purgato M,Churchill R,Barbui C

    更新日期:2020-09-04 00:00:00

  • Topical treatments for scalp psoriasis.

    abstract:BACKGROUND:People with chronic plaque psoriasis often have lesions on the scalp. Hair makes the scalp difficult to treat and the adjacent facial skin is particularly sensitive to topical treatments. OBJECTIVES:To assess the efficacy and safety of topical treatments for scalp psoriasis. SEARCH METHODS:We searched the ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Schlager JG,Rosumeck S,Werner RN,Jacobs A,Schmitt J,Schlager C,Nast A

    更新日期:2016-02-26 00:00:00

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    abstract:BACKGROUND:Vitamin B6 plays vital roles in numerous metabolic processes in the human body, such as nervous system development and functioning. It has been associated with some benefits in non-randomised studies, such as higher Apgar scores, higher birthweights, and reduced incidence of pre-eclampsia and preterm birth. ...

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    authors: Thaver D,Saeed MA,Bhutta ZA

    更新日期:2006-04-19 00:00:00

  • Body weight management in overweight and obese breast cancer survivors.

    abstract:BACKGROUND:Studies suggest that overweight and obese breast cancer survivors are at increased risk of cancer recurrence and have higher all-cause mortality. Obesity has an impact on breast cancer survivor's quality of life (QOL) and increases the risk of longer-term morbidities such as type 2 diabetes mellitus and card...

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    authors: Shaikh H,Bradhurst P,Ma LX,Tan SYC,Egger SJ,Vardy JL

    更新日期:2020-12-11 00:00:00

  • Feverfew for preventing migraine.

    abstract:BACKGROUND:This review is an update of a previously published review in the Cochrane Database of Systematic Reviews on 'Feverfew for preventing migraine' (2004, Issue 1). Feverfew (Tanacetum parthenium L.) extract is a herbal remedy, which has been used for preventing attacks of migraine. OBJECTIVES:To systematically ...

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    authors: Wider B,Pittler MH,Ernst E

    更新日期:2015-04-20 00:00:00

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    abstract:BACKGROUND:Uterine fibroids cause heavy prolonged bleeding, pain, pressure symptoms and subfertility. The traditional method of treatment has been surgery as medical therapies have not proven effective. Uterine artery embolization has been reported to be an effective and safe alternative to treat fibroids in women not ...

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    authors: Gupta JK,Sinha A,Lumsden MA,Hickey M

    更新日期:2014-12-26 00:00:00

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    abstract::This is the protocol for a review and there is no abstract. The objectives are as follows: The objective of the review will be to determine the efficacy and tolerability of eletriptan compared to placebo and other active interventions in the treatment of acute migraine headaches in adults. ...

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    abstract:BACKGROUND:Cardiac tamponade may occur following cardiac surgery as a result of blood or fluid collecting in the pericardial space compressing the heart and reducing cardiac output. Mediastinal chest drains (including pericardial drains) are inserted as standard post-operative practice following cardiac surgery to assi...

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    authors: Wallen M,Morrison A,Gillies D,O'Riordan E,Bridge C,Stoddart F

    更新日期:2004-10-18 00:00:00

  • Dressings and topical agents for preventing pressure ulcers.

    abstract:BACKGROUND:Pressure ulcers, localised injuries to the skin or underlying tissue, or both, occur when people cannot reposition themselves to relieve pressure on bony prominences. These wounds are difficult to heal, painful, expensive to manage and have a negative impact on quality of life. Prevention strategies include ...

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    authors: Moore ZE,Webster J

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    abstract:BACKGROUND:Hydration has been proposed as a treatment for women with preterm labour. Theoretically, hydration may reduce uterine contractility by increasing uterine blood flow and by decreasing pituitary secretion of antidiuretic hormone and oxytocin. OBJECTIVES:To evaluate the effectiveness of intravenous or oral hyd...

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    abstract:BACKGROUND:Bisphosphonates are specific inhibitors of osteoclastic activity and are currently used as supportive therapy for multiple myeloma (MM). However, the exact clinical role of bisphosphonates in MM remains unclear. OBJECTIVES:This update of the first review published in 2002. We have also analyzed observationa...

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    authors: Mhaskar R,Redzepovic J,Wheatley K,Clark OA,Miladinovic B,Glasmacher A,Kumar A,Djulbegovic B

    更新日期:2010-03-17 00:00:00

  • WITHDRAWN: Interventions for guttate psoriasis.

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  • WITHDRAWN: Periconceptional supplementation with folate and/or multivitamins for preventing neural tube defects.

    abstract:BACKGROUND:Neural tube defects arise during the development of the brain and spinal cord. OBJECTIVES:The objective of this review was to assess the effects of increased consumption of folate or multivitamins on the prevalence of neural tube defects periconceptionally (that is before pregnancy and in the first two mont...

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    更新日期:2011-04-13 00:00:00

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    abstract:BACKGROUND:Viral bronchiolitis is a common cause of respiratory failure in infants and children, and accounts for a significant portion of intensive care unit (ICU) admissions during seasonal epidemics. Currently there is no evidence to support the use of anything but supportive care for this disease. Surfactant is a p...

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    更新日期:2006-07-19 00:00:00

  • Effects of total fat intake on body fatness in adults.

    abstract:BACKGROUND:The ideal proportion of energy from fat in our food and its relation to body weight is not clear. In order to prevent overweight and obesity in the general population, we need to understand the relationship between the proportion of energy from fat and resulting weight and body fatness in the general populat...

    journal_title:The Cochrane database of systematic reviews

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    authors: Hooper L,Abdelhamid AS,Jimoh OF,Bunn D,Skeaff CM

    更新日期:2020-06-01 00:00:00

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    更新日期:2020-01-06 00:00:00

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    authors: Bailey EJ,Cates CJ,Kruske SG,Morris PS,Chang AB,Brown N

    更新日期:2009-01-21 00:00:00

  • Bifeprunox versus placebo for schizophrenia.

    abstract:BACKGROUND:Bifeprunox is a novel antipsychotic drug designed to treat schizophrenia. However, research into the drug was ceased in 2009 due to rejection of licence to go to market by the US Food and Drug Administration (FDA), who could not approve the drug for acute or long-term symptoms of schizophrenia because more r...

    journal_title:The Cochrane database of systematic reviews

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    authors: Chattopadhyay A,Frey S,Green G

    更新日期:2016-10-12 00:00:00

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    pub_type: 杂志文章,评审


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    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Sudlow C,Warlow C

    更新日期:2002-01-01 00:00:00

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    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析


    authors: Skilton M,Krishan A,Patel S,Sinha IP,Southern KW

    更新日期:2019-01-07 00:00:00

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    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析


    authors: Fullerton B,Siebenhofer A,Jeitler K,Horvath K,Semlitsch T,Berghold A,Gerlach FM

    更新日期:2018-12-17 00:00:00