7. Haloperidol and Other First Generation Antipsychotics in Mania

  1. Hagop S. Akiskal2 and
  2. Mauricio Tohen3
  1. John Cookson

Published Online: 13 APR 2011

DOI: 10.1002/9780470975114.ch7

Bipolar Psychopharmacotherapy: Caring for the Patient, Second Edition

Bipolar Psychopharmacotherapy: Caring for the Patient, Second Edition

How to Cite

Cookson, J. (2011) Haloperidol and Other First Generation Antipsychotics in Mania, in Bipolar Psychopharmacotherapy: Caring for the Patient, Second Edition (eds H. S. Akiskal and M. Tohen), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9780470975114.ch7

Editor Information

  1. 2

    International Mood Center, University of California at San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0603, USA

  2. 3

    Department of Psychiatry, Division of Mood and Anxiety Disorders, University of Texas Health Science Centre at San Antonio, 7730 Floyd Curl Drive, San Antonio, TX 78229, USA

Author Information

  1. The Royal London Hospital, Burdett House, Mile End Hospital, Bancroft Road, London E1 4DG, UK

Publication History

  1. Published Online: 13 APR 2011
  2. Published Print: 15 APR 2011

ISBN Information

Print ISBN: 9780470747216

Online ISBN: 9780470975114

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Keywords:

  • dopamine (DA);
  • Acute Tranquillization in Mania;
  • lorazepam (LZP);
  • Chlorpromazine in Mania;
  • Clinical Global Impression (CGI);
  • Cortisol;
  • Prolactin;
  • Pharmacoeconomics

Summary

For over 50 years, antipsychotics have been the most commonly used drugs for the treatment of mania. Haloperidol has been one of the most widely used. The clinical trials of new generation antipsychotics in mania, sponsored by the pharmaceutical manufacturers, have answered many important questions about bipolar disorder that were unresolved. In particular, they have shown that antipsychotics generally have specific antimanic properties that are independent of sedation or psychosis. The speed of action and size of effect of antipsychotics makes them especially useful for the control of emergent (hypomanic) symptoms and for acute tranquillization in mania. None of the atypicals has proved more effective than haloperidol in reducing manic symptoms, some of them are less so; but all produce fewer extrapyramidal side effects than haloperidol and may therefore be more acceptable to patients. This chapter reviews the evidence concerning the use of first generation antipsychotics in mania.