Pharmacotherapy Newsletter

Volume 1, Issue 30, 08/10/2009

Question

What is the mechanism by which the antipsychotic haloperidol (Haldol®) can cause tardive dyskinesia?

Answer

Schizophrenia is known to affect over 2 million adults in America and over 300,000 adults in Canada.(1,2)  The life-time prevalence of schizophrenia in the United States has been estimated to be 0.2% - 1.5%.(3,4)  The DSM-IV-TR diagnostic manual presents schizophrenia as a major psychiatric disorder commonly associated with a various combination of symptoms that are categorized into being either positive, negative or disorganized symptoms.(3)  Positive symptoms include hallucinations and delusions, whereas negative symptoms include having a flat affect (no emotional expression), alogia (reduced thought and speech productivity), and avolition (decreased initiation of goal directed behavior).  Disorganized symptoms include disorganized speech, behavior, and poor attention.(3)  The approach to treatment of this disorder has historically centered around the modulation of the dopaminergic and serotonergic pathways in the central nervous system.(4)  In particular, it is known that the...

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