Faculty Bibliography

In this double-blind, placebo-controlled study the administration of haloperidol resulted in significant decreases in behavioral symptoms and in general clinical improvement in 40 autistic children ages 2.33 to 6.92 years. Haloperidol also produced greater facilitation and retention of discrimination learning in the laboratory. No adverse effects were observed at therapeutic doses, which ranged from 0.5 to 3.0 mg/day or 0.019 to 0.217 mg/kg per day

The reliability of saliva lithium levels in monitoring serum lithium levels in children taking lithium has rarely been studied, despite the potential usefulness of such a study and despite a number of adult studies focusing on the technique. In a study of 61 aggressive school-age children diagnosed as undersocialized, aggressive conduct disorder, a subsample of 21 children received lithium. Saliva lithium levels aided in monitoring side effects, and in 15 of the 21 children simultaneous saliva and serum lithium levels were done. These were highly correlated (r = 0.83) and the saliva to serum ratio was 2.53 across subjects. The results indicate that future work with larger numbers of children should study the ratio of saliva to serum lithium levels. Adult studies have shown that there is too great a variability in saliva to serum lithium level ratios to support the use of a fixed saliva to serum lithium ratio. This may not be the case in children. Seventeen children from the lithium subsample experienced 41 lithium-related side effects. Most children suffered side effects on relatively high doses of lithium, and those few who experienced side effects on low dosage had saliva lithium levels that were proportionately high. However, it remains unclear whether saliva lithium can be used to monitor side effects.

The efficacy and safety of haloperidol, lithium carbonate, and placebo were critically assessed in 61 treatment-resistant, hospitalized children aged 5.2 to 12.9 years with diagnoses of conduct disorder, aggressive type. In this double-blind and well-controlled study, the optimal dosages of haloperidol ranged from 1.0 to 6.0 mg/day and those of lithium carbonate from 500 to 2,000 mg/day. For the assessment of behavioral changes and untoward effects, various rating scales were used in different settings. Both haloperidol and lithium carbonate were found to be significantly superior to placebo in decreasing behavioral symptoms. Although both medications were clinically effective, haloperidol was associated more often with untoward effects than was lithium carbonate

The effects of haloperidol on behavioral symptoms and learning were critically assessed in autistic children in an ongoing double-blind placebo-controlled clinical trial. Children were randomly assigned to haloperidol-placebo-haloperidol or placebo-haloperidol-placebo treatment sequences. Statistically, haloperidol was significantly superior to placebo in reducing behavioral symptoms. In discrimination learning paradigm, children receiving haloperidol learned the discrimination while those on placebo did not. Discrimination attained on haloperidol was retained when the children were switched to placebo

A comparison of the effects of lithium, haloperidol, and placebo on cognition is reported for a sample of hospitalized school-age children with a behavioral profile of aggressiveness and explosiveness. In this double-blind study, patients were randomly assigned to one of three treatment conditions. The cognitive battery was administered at the end of a 2-week placebo baseline period and again after 4 weeks of treatment. It included a simple reaction time (RT) task with preparatory intervals of 1, 4, and 8 seconds, the Porteus Mazes, and the Matching Familiar Figures Test. Drug effects on cognition, when found, were mild. Slower and more variable RTs were found on the RT task in the haloperidol group (mean dose, 3.1 mg/day), particularly at the 4- and 8-second preparatory intervals in comparison to placebo. This appeared to reflect decreased ability to hold a preparatory set. No other effects of haloperidol on cognitive performance were found. Lithium carbonate (mean dose, 1150 mg/day) caused a deterioration in qualitative performance on the Porteus Maze Test when compared with haloperidol but had no effect on test quotient scores or on the other cognitive measures. Results are discussed in terms of dose effects and the influences of task demands. This is part of a study critically assessing the effects of lithium and haloperidol on behavioral symptoms and other parameters