Bioavailability of intramuscular versus oral haloperidol in schizophrenic patients

RAPID tranquilization is a treatment method that has been employed to treat acutely psychotic patients (usually schizophrenic or manic) by the administration of antipsychotic medication at frequent intervals over a short time period until symptoms are reduced. The most common form of rapid tranquilization involves the use of intramuscularly administered neuroleptic drugs, usually haloperidol, ranging from 2 to 10 mg per injection every 30 to 60 min during the first day of treatment. In both open and double-blind studies, this technique has been found to be efficacious in ameliorating such troublesome acute symptoms as agitation, belligerence, self-destructive behavior, and core schizophrenic symptoms, including delusions, hallucinations, and thought disorganization¹. Now that rapid tranquilization has been accepted as a valuable therapeutic tool, it would be of clinical importance to determine whether oral administration can replace intramuscular administration in the compliant patient if the oral dose is raised to compensate for differences in bioavailability.