R M Dardennes

Publications (2)3.37 Total impact

• Article: Haloperidol blood levels and clinical outcome: a meta-analysis of studies relevant to testing the therapeutic window hypothesis.

  I R de Oliveira, E P de Sena, E L Pereira, A M Miranda, N F de Oliveira, M G Ribeiro, E de Castro-e-Silva, R M Dardennes, B Samuel-Lajeunesse, C Marcilio
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  ABSTRACT: Haloperidol, the most studied antipsychotic drug, is the only one about which reliable statements on the relationship between blood levels and clinical outcome can be made. A systematic overview was undertaken to determine whether there was an optimum blood concentration range for clinical efficacy. Eighteen published studies which provided individual patient data in tables or graphs were reviewed. Clinical benefits tended to decline when the haloperidol blood concentration was increased above 26 ng/ml. Our data support the existence of a therapeutic window between 4 and 26 ng/ml for haloperidol in the treatment of schizophrenic, schizoaffective and schizophreniform disorders.
  Journal of Clinical Pharmacy and Therapeutics 09/1996; 21(4):229-36. · 1.57 Impact Factor
• Article: Is there a relationship between antipsychotic blood levels and their clinical efficacy? An analysis of studies design and methodology.

  I R de Oliveira, R M Dardennes, E S Amorim, B Diquet, E P de Sena, E C Moreira, E J de Castro-e-Silva, C Payan, J Fermanian, C Marcílio
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  ABSTRACT: There are now more than 50 studies concerning neuroleptic blood levels and clinical outcome relationships. Haloperidol, the most studied, is the only antipsychotic permitting some conclusions. A number of authors suggest that the striking lack of agreement between different studies results from heterogeneity of their quality. Here, we have used a scoring system for assessing the quality of those studies. According to this system, none (0/14) of the studies having a score < 0.60 was able to show a therapeutic window, as compared to 53% (10/19) of those having a score > or = 0.60 (p = 0.002, Fisher exact test). Also, the studies able to identify the presence of a therapeutic window during haloperidol treatment were those having sample size > 20 (p = 0.06) and those whose patients were treated with fixed doses (p = 0.02). The diagnosis of schizophrenia in the studies seems not to be an exclusive condition, as compared with those also including schizophreniform and schizoaffective disorders (p = 0.12). Our qualitative analysis of haloperidol blood level publications seem to indicate that an upper limit may exist for haloperidol efficacy; values above this limit seem not to provide any supplementary clinical improvement and may even reduce therapeutic effect.
  Fundamental and Clinical Pharmacology 01/1995; 9(5):488-502. · 1.80 Impact Factor