Typical Antipsychotics Research Articles (Page 1)

Psychotropic drugs and risk of pancreatitis: a systematic review and meta-analysis.

A retrospective study on clozapine-induced blood dyscrasias in the first 20weeks of therapy.

Association between the exposome score for schizophrenia and functioning in remitted first-episode psychosis: results from the HAMLETT study.

Psychosis in Huntington's disease: A systematic review of case reports.

Background/Objectives: The objective of this study is to investigate the patterns and characteristics of medication errors (MEs) associated with antipsychotic medication use in hospitals affiliated with the Ministry of Health (MOH) in Saudi Arabia and to identify areas for improvement. Methods: A retrospective descriptive analysis of MEs associated with antipsychotic use was conducted using data collected from MOH-affiliated hospitals between April 2020 and September 2022. The data were analyzed descriptively to identify the factors underpinning unsafe antipsychotic use. Results: The sample period produced 35,077 reported MEs. Reports from the Western region contributed the highest error percentage, and MEs were reported more frequently in male (76.1%, n = 26,705) and adult (97.7%, n = 34,275) patients. Pharmacists reported MEs more often than other healthcare professionals (66.5%, n = 23,312). Most MEs (89.9%, n = 31,524) originated in the prescribing stage, with missing prescription information being the most frequently reported ME type (40.5%, n = 14,206). Atypical antipsychotics accounted for the greatest proportion of reports (79.3%, n = 27,811) compared to typical antipsychotics (20.7%, n = 7262). Most ME outcomes fell into Category B: The error occurred but did not reach the patient (56.4%, n = 19,794). Factors related to staffing or workflow accounted for 21.3% (n = 7467) of the reported errors, followed by a lack of policies in relation to antipsychotics prescribing and monitoring (20.5%; n = 7195). Conclusions: MEs in hospitals in Saudi Arabia frequently involve antipsychotic medications. This study identified important targets that may help reduce such risks in the future.

BACKGROUND: Despite the critical relevance of treating psychoses induced by synthetic cathinones, existing studies only describe treatment strategies without further analysis. This article systematizes the approaches used to treat psychoses associated with the use of synthetic cathinones. AIM: To identify the strategies applied in the treatment of cathinone-induced psychoses, and to compare the duration of psychoses, the dynamics of positive symptoms, and the severity of cognitive impairments when using different therapeutic strategies. METHODS: The study included 98 patients over 18 years of age with a psychotic disorder, synthetic cathinones or their metabolites were detected in biological fluids using gas chromatography-mass spectrometry. The Brief Psychiatric Rating Scale (BPRS) was used on day 1 and day 10 of psychosis to objectively assess the dynamics of psychotic symptoms. After the resolution of psychosis, the Mini-Mental State Examination (MMSE) was used to assess cognitive impairments. RESULTS: Four therapeutic strategies were described: 1) infusion therapy and benzodiazepines; two strategies where the basic approach was supplemented with either 2) typical or 3) atypical antipsychotics; and 4) a strategy involving forced diuresis and propofol. One-way ANOVA demonstrated significant differences between the strategy used and the duration of psychosis (F=17.52; R²=0.3586; p0.0001). Analysis of BPRS scores between day 1 and 10 revealed significant changes (F=347.5; p0.0001). The reduction in scores was 52.1% with the basic strategy (q=2.732, p0.0001), 45% with the typical antipsychotics (q=3.020, p0.0001), 22.2% with the atypical antipsychotics (q=3.874, p=0.0074), and 53.3% with the forced diuresis and anesthetics (q=3.139, p0.0001). MMSE scores showed the mean score after the resolution of psychotic symptoms was 25.9±0.75. Intergroup analysis did not reveal significant differences (F=0.6731, R²=0.02060, p=0.5706). CONCLUSION: Standardizing approaches to treating substance-induced psychoses is an important step in developing a care pathway for such patients. Our study systematized the approaches to therapy for these conditions and compared specific psychometric indicators across different treatment strategies

Background: Schizophrenia (SCZ) is a psychiatric disorder that negatively impacts patients’ quality of life, frequently inducing difficulties in managing day-to-day tasks. Current research is persistently working on finding therapeutic methods to alleviate the positive and negative symptoms, as well as the associated cognitive dysfunctions. Since the main therapeutic approach in SCZ is antipsychotics, the current study aimed to explore the effects of typical (haloperidol, HAL) vs. atypical (risperidone, RIS) antipsychotics on the cognitive functions in an animal model (Danio rerio) of SCZ, obtained by ketamine (KET) administration. Methods: The cognitive evaluation of the zebrafish was performed using memory and learning tests based on two stimuli: food and colours (i.e., T memory test and novel object recognition (NOR) test, respectively). Results: According to the behavioural analyses, HAL significantly enhanced the cognitive performances of the SCZ model, as compared to RIS. Nonetheless, HAL and RIS exhibited comparable effects on social behaviour in the SCZ model. Interestingly, both HAL and RIS enhanced the interest for the novel object in the NOR test in control individuals, but significantly decreased it in the SCZ model. The interaction between KET and RIS could exhibit sedative properties. Conclusions: Both typical (HAL) and atypical (RIS) antipsychotics alleviated cognitive, socio-affective, and decision-making impairments in a ketamine-based adult zebrafish model of schizophrenia. HAL was more effective, particularly in food-stimulated decision-making compared to novel object or social stimuli. Colour influenced behavioural responses, with silver linked to prey/feeding effects and red perceived as aversive. The KET–RIS combination induced exploratory impairments, possibly due to sedative effects. These findings highlight differential pharmacological and ethological modulation of schizophrenia-like behaviours.

Significant changes in Taiwan's psychiatric services over recent decades include expansion of community-based clinics and implementation of the Schizophrenia Pay-for-Performance programme. This study aimed to assess the trend of the quality of healthcare for individuals with schizophrenia, using various indicators of the treatment process and outcomes between 2010 and 2019. Individuals with schizophrenia were identified using Taiwan's National Health Insurance claims database. The quality of healthcare for individuals with schizophrenia was assessed using treatment process and outcome indicators, including antipsychotic types, medication adherence, daily dose for antipsychotics and concurrent use of other psychotropic agents. Outcome indicators included all-cause mortality, suicide deaths, psychiatric hospitalisation, emergency department visits and employment status. Antipsychotic medication usage has shifted towards second-generation antipsychotics (SGAs) and long-acting injectable antipsychotics (LAIs), with declines in first-generation antipsychotics. The percentage of medication adherence declined, while that of individuals with an adequate daily dose increased. Concurrently, anticholinergic and benzodiazepine use decreased while antidepressant and mood stabiliser use increased. Outcome indicators showed no significant change in all-cause mortality or suicide rates over time, but there were reductions in psychiatric hospitalisations and emergency department visits. Employment rates increased overall, particularly in urban areas. The quality of healthcare for individuals with schizophrenia, as measured by treatment process and outcome indicators, improved alongside changes in Taiwan's psychiatric services; however, causality cannot be inferred from our findings. Future research should evaluate the effectiveness of psychiatric service policies and continuously monitor healthcare quality to further enhance the lives of individuals with schizophrenia.

Muscarinic agonists represent a new class of treatments for psychosis with a mechanism distinct from typical and atypical antipsychotics. The muscarinic subtype M4 has been proposed as the primary mediator of efficacy but results from recent clinical trials with M4-selective compounds have drawn this hypothesis into question. Instead, activation of both M1 and M4 receptor subtypes may be required for robust treatment effects. Here, we characterize the clinical-stage muscarinic agonist ML-007 in preclinical models and explore its therapeutic potential for treating psychosis in schizophrenia and Alzheimer's disease. ML-007 is a potent brain-penetrant agonist at both M1 and M4 muscarinic receptors that has demonstrated compelling efficacy across a range of preclinical models of psychosis in schizophrenia including amphetamine-induced hyperlocomotion, PCP-induced hyperlocomotion, and conditioned avoidance response. Moreover, ML-007 is approximately ten-fold more potent than the comparator xanomeline in all animal models. Dose-response experiments in M1 and M4 knockout mice reveal that the efficacy of ML-007 is dependent on both M1 and M4 receptors. Taken together, our data suggest that both M1 and M4 receptors contribute to the potent efficacy of ML-007 in preclinical rodent models of psychosis.

Investigation into neuroleptic malignant syndrome triggered by atypical antipsychotics: Insights from FDA adverse event reporting system database.

INTRODUCTION: Auditory hallucination (AH) is the most common type of hallucinations in individuals with schizophrenia. Assessing the multidimensional aspects of AH provides more precise insights, particularly regarding associated psychological sequelae. This study aimed to examine the short-term effects of antipsychotics treatment on the emotional, cognitive and physical dimension of AH. MATERIALS AND METHODS: A total of 74 patients with schizophrenia with relapsing episodes were recruited. The Psychotic Symptoms Rating Scale subscale Auditory Hallucination.(PSYRATS-AH) was administered at baseline, and after 2 weeks and 4 weeks of treatment. Patients were treated with atypical, typical, or a combination of both types of antipsychotics. The emotional, cognitive and physical components of PSYRATS-AH were analysed. RESULTS: Most participants were Malay (89.2%), single (63.5%), unemployed (70%), and on atypical antipsychotic treatment (71.6%). At 4 weeks, there was a significant reduction in overall AH scores compared to baseline. Both atypical and combination antipsychotic regimen showed a significant difference in all three components, namely emotional (χ2=43.9, p<0.05 and χ2=27.8, p<0.05), cognitive (χ2=34.1, p<0.05 and χ2=19.0, p<0.05), and physical (χ2=39.5, p<0.05 and χ2=30.5, p<0.05). However, those on typical antipsychotic showed a poorer response in the physical component (χ2=5.4, p>0.05). CONCLUSION: Atypical and combination antipsychotic regimen demonstrated greater effectiveness in improving the emotional, cognitive, and physical dimension of AH. Typical antipsychotics alone were less effective, particularly in addressing physical symptoms. These findings support the preferential use of atypical antipsychotics managing the multidimensional aspects of AH in schizophrenia.

Aim: Delirium is a sudden disturbance in mental functioning characterized by impaired attention, reduced concentration, and disorientation. A rising cause of delirium are novel psychoactive substances (NPS) – emerging drugs designed to mimic the effects of controlled substances while evading legal restrictions. The management of NPS-induced delirium remains challenging due to the lack of established guidelines. Treatment is primarily symptomatic, managing symptoms with benzodiazepines and typical antipsychotics (mostly haloperidol). This paper highlights olanzapine as a potentially effective option for treating NPS-induced delirium, particularly in cases where gamma-hydroxybutyrate (GHB) is abused. Case report: A patient dependent on NPS (GHB and mephedrone) developed delirium due to withdrawal syndrome. The patient presented with hallucinations, disorientation, dissociative speech, agitation, insomnia, attention and concentration disturbances, and autonomic instability. In addition to the usual delirium therapy (haloperidol, anxiolytics), the patient was treated with oral olanzapine, resulting in symptom resolution. This paper demonstrates the successful treatment of NPS-induced delirium with olanzapine. Conclusion: Broad receptor binding profile of olanzapine in the brain contributes to its efficacy in alleviating hallucinations, agitation, and autonomic disturbances. However, there is a need for further research to establish optimal treatment protocols for NPS-induced delirium to ensure the best possible care for patients affected by this challenging condition.

Disease relapse, all-cause mortality, and adverse events associated with long-acting injectable antipsychotics versus oral antipsychotics in older people with schizophrenia in Hong Kong: a population-based within-subject analysis.

IntroductionDelirium, as described in the DSM-V, is a disruption in attention and consciousness that develops over a brief period, representing an acute change from baseline awareness. First-generation antipsychotics, such as haloperidol, are often advised as the first line of pharmacological treatment. In comparison to haloperidol, olanzapine appears to be more beneficial in terms of efficacy and safety, according to a 2016 systematic review and meta-analysis of randomized clinical studies. However, most of the research included were single-center investigations with tiny sample numbers, diverse study demographics, and bias potential.ObjectivesThe aim of this systematic review was to identify the current best evidence on the effectiveness of olanzapine versus haloperidol in various clinical settings to guide best practices for healthcare professionals. Also, this literature review seeks to provide a up-to-date synthesis of the current evidence on this subject.MethodsWe conducted a systematic search of four databases (PubMed, PsycINFO, CINAHL, and Cochrane Central) from inception through January 31st, 2024, using keywords related to delirium (acute confusion, confusion state, confusional state), olanzapine, and haloperidol. The search was limited to randomized controlled trials comparing olanzapine with haloperidol, without restrictions on dose, route of administration, or drug exposures. When analyzing outcomes with a robust number of studies, we applied a random-effects model. For outcomes with fewer studies, we used a fixed-effects model. Additionally, we conducted sensivity and subgroup analyses. All statistical evaluations were performed using the RevMan software.ResultsSeven studies met our inclusion criteria. Haloperidol was associated with a significantly lower severity of delirium after 2-3 days of treatment compared to olanzapine, with a small effect size (g = 0.40, 95% CI [0.02; 0.78], p = 0.04) based on three studies (n = 110). However, no significant difference was observed after 4-7 days (g = 0.09, 95% CI [-0.26; 0.44], p = 0.61) across five studies (n = 306). There was no significant difference in overall side effect rates between haloperidol and olanzapine (p = 0.29, 7 studies, n = 530), but haloperidol resulted in significantly more extrapyramidal side effects (p = 0.008). Sedation as an adverse effect did not differ significantly between the two drugs (p = 0.54, 4 studies, n = 284).ConclusionsHaloperidol may offer superior short-term efficacy in reducing delirium severity but is associated with a higher risk of extrapyramidal symptoms. No significant differences were found in long-term efficacy or sedation rates between olanzapine and haloperidol. These findings support the need for careful consideration of drug safety profiles in the treatment of delirium.Disclosure of InterestNone Declared

IntroductionPatients suffering from severe mental disorders have a reduced life expectancy of approximately 10-25 years compared to the general population. This mortality gap is mainly due to physical comorbidities among which metabolic disorders play a significant role.ObjectivesIn our study we used the Body Mass Index (BMI), an indicator of general health that can be easily calculated in daily clinical practice, to investigate how weight and the different psychopathological and psychosocial dimensions mutually influence each other in patients with mental disorders.MethodsThis naturalistic observational multicenter study was carried-out in 7 Italian university centers (Universities of Campania “L. Vanvitelli,” Catania, Magna Graecia of Catanzaro, Cattolica del Sacro Cuore of Rome, Padova, Sapienza University of Rome, and Tor Vergata of Rome). Patients were recruited if they: 1) had diagnosis of bipolar disorder (BD) or major depressive disorder (MDD) according to DSM-5 criteria; 2) had an age between 18 and 65 years; 4) were in a stable phase of the disease (total score < 9 on the Hamilton Rating Scale for Depression and a score of ≤11 on the Young Mania Rating Scale). Affective temperaments were assessed with the Munster Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego, impulsivity with the Barratt Impulsiveness Scale, and suicidal ideation with the Columbia Suicide Severity Rating Scale.ResultsA total of 598 patients were recruited, of which 60.9% affected by DB and 39.1% by MDD. Univariate analyzes revealed an association between higher BMI and male gender (p<0.001), BD diagnosis (p<0.001), high levels of impulsivity (p<0.05), presence of psychotic symptoms during the acute phases of illness (p<0.05), greater number of hospitalizations (p<0.01), cigarette smoking (p<0.05) and depressive temperament (p<0.001). Furthermore, patients treated with lithium (p<0.05), antiepileptics (p<0.05) and first-generation antipsychotics (p<0.001) had a significantly higher BMI compared to those not taking the aforementioned pharmacological treatments.ConclusionsThe results of our study highlight a strong link between BMI and some clinical outcomes in patients with affective disorders. The routinary assessment of these outcomes would be useful for the early identification of potential metabolic comorbidities as well as to identify patients at higher risk to develop a worse outcome.Disclosure of InterestNone Declared

IntroductionMotherhood represents a challenge for all women, but it’s even more complex for those suffering from serious psychiatric illnesses such as Bipolar Disorder, Schizophrenia and Schizoaffective Disorder. The treatment of these women requires special care during the preconception, prenatal and postnatal phases, taking into account the risk of decompensation, the psychosocial factors involved and the difficult balance between the potential harm to the foetus and/or infant and the risks associated with not treating the mother. With the scarcity of randomised clinical trials and limited evidence, clinical practice guidelines become essential to determine the best therapeutic approaches to adopt.ObjectivesTo systematise the best evidence of care for pregnant and/or postpartum women with a history of psychotic illness.MethodsSystematic literature review.ResultsMental health management in women with severe psychiatric illness who want to become pregnant should involve shared decision-making and multidisciplinary counselling. In women of childbearing age who are diagnosed with such conditions, adequate awareness of the illness and the need for family planning is the first step towards effective and safe long-term treatment. In the prenatal period, it’s essential to monitor early signs of relapse, to psychoeducate about the need to stop comorbid consumption and to carry out additional foetal ultrasounds at specific times to rule out malformations in foetuses exposed to antipsychotics and lithium. In the postnatal period, the risk of relapse is especially high. Careful monitoring in the first month after birth and regular review thereafter are essential. When necessary, hospitalisation in mother-baby units is the gold standard treatment. Pharmacological treatment of pregnant and breastfeeding women should weigh up the risks associated with non-intervention and the potential adverse effects on the foetus and lactating infant. The choice of psychotropic drugs should taking into account the varying safety profiles; for example, typical antipsychotics can cause extrapyramidal symptoms or withdrawal syndrome in the newborn and atypical antipsychotics metabolic syndrome. Nevertheless, despite the quality of the evidence, antipsychotics appear to be generally safe in pregnancy and breastfeeding.ConclusionsThe management of mental health care for this subpopulation must ensure that decisions are shared, follow-up is multidisciplinary, pre- and post-natal monitoring is individualised and pharmacological treatment is chosen based on the best balance between the needs of the mother and the safety of the foetus/infant.Disclosure of InterestNone Declared

IntroductionNegative symptoms pose a significant challenge for the treatment and management of schizophrenia. They refer to the loss or diminishment of normal emotional and behavioural functions, which profoundly impact one’s quality of life and socio-occupational outcomes. They are often persistent and difficult to treat.ObjectivesTo explore and assess different treatment strategies for addressing negative symptoms of schizophrenia, including pharmacological, psychosocial, and non-invasive neurostimulation interventions. The goal is to provide an overview of current evidence and recommendations for enhancing the quality of life and functional outcomes in individuals with schizophrenia.MethodsWe conducted a review of the extant literature to determine treatment strategies for negative symptoms in schizophrenia. We incorporated findings from randomised controlled studies, meta-analyses and systematic reviews.ResultsWe have identified several treatment strategies for negative symptoms in schizophrenia. The literature indicates that second generation antipsychotics such as Cariprazine and Amisulpride are associated with better functional outcomes with lower cognitive impairment. Adding on an anti-depressant, particularly to first-generation antipsychotics, has demonstrated positive effects. Psychosocial interventions including Cognitive Remediation (CR), Social Skills Training (SST) and exercise programs also alleviate negative symptoms. Additionally, non-invasive neurostimulation intervention such as rTMS applied to the left dorsolateral prefrontal cortex (DLPFC) has shown encouraging results in reducing negative symptoms.ConclusionsThe findings highlight the important of comprehensive and holistic treatment approach integrating both pharmacotherapy and non-pharmacotherapy strategies to address the heterogeneity of negative symptoms. There is a need for further research into personalised treatments that address individual symptom profiles.Disclosure of InterestNone Declared

IntroductionThe World Health Organization defines non-adherence to treatment as “a situation where an individual’s medication-taking behavior diverges from the agreed recommendations of healthcare professionals”. Individuals with psychiatric disorders frequently encounter challenges in adhering to their prescribed treatments, which is due amon other factors to a lack of insight. The non-adherence can lead to increased relapse rates, diminished treatment efficacy over time, and adverse effects on both the individual and the broader community.ObjectivesThis study’s objectives were towfold : (1) to investigate medication adherence among patients with schizophrenia and bipolar disorders under antipsychotics, and (2) to identify various factors associated with non-adherence to antipsychotic treatments.MethodsA cross-sectional study was conducted at Razi Hospital, Tunisia, between December 2023 and January 2024. Were included patients who attended the outpatient clinic during the study period, who were in remission for at least one month and who were receiving antipsychotic medication. The Brief Adherence Rating Scale, the Positive and Negative Syndrome Scale and the Glasgow Antipsychotic Side-effects Scale were administered to all patients.ResultsThe study included 35 male patients with a mean age of 39 years ± 11 years. Schizophrenia was diagnosed in 86% (N=30) of the participants. Of these, 49% were prescribed first-generation antipsychotics (N=17), while 51% (N=18) were prescribed second-generation antipsychotics. More than half of the patients (63%) demonstrated non-adherence to their treatment regimen. Among these, 65% exhibited moderate to severe lack of insight into their illness, and 66% had not received psychoeducation about their condition. A significant association was found between non-adherence and moderate to severe lack of insight (p=0.000, OR=4, 95% CI [1.4-10]), lack of psychoeducation for the patient (p=0.02, OR=2, 95% CI [1-4.3]), and lack of psychoeducation for the caregiver (p=0.05, OR=1.7, 95% CI [0.9-3.2]). Binary logistic regression analysis indicated that lack of insight (p=0.01, OR=3.6) remained a significant risk factor for non-adherence.ConclusionsThis study underscores significant association between lack of insight and non-adherence to antipsychotic medications. Enhancing insight through early psychoeducational interventions could potentially improve medication adherence and positively influence long-term clinical and functional outcomes for patients.Disclosure of InterestNone Declared

The recent development of the socalled “psychedelics” reminds us that unfortunately some medications which we used in psychiatry have a large burden of side effects, like the anticholinerg side effects of the older tricyclic antidepressants as well as the extrapyramidal motoric side effects of socalled typical neuroleptics. These side effects were sometimes also related to the efficacy of these medications. Interestingly, it seems that the neglection of side effects is still an unresolved issue in clinical psychopharmacology, since there are researchers and clinicians who argue that the psychedelic experience induced with psychedelics are associated with therapeutic efficacy. Furthermore, studies in this field not even mention these side effects as such and argue, when confronted with the issue, that these are necessary for the therapeutic outcome. Even more so, there are researchers and clinicians who think that these side effects allow the patients to understand their unconscious, like in the early days of psychoanalysis. However, recent preclinical animal models demonstrated antidepressant-like behavioral effects and synaptic actions that are not only linked to the serotonergic activation (mainly via the 5HT2A receptor), but also via opioid and glutamatergic pathways which share neurobiological mechanisms of network reconfiguration likely by intracellular plasticity cascades. It seems to be important from my point of view to develop antidepressant medications devoid of the side effect of psychedelic experience in order to produce a safer, non-hallucinogenic medication that has therapeutic potential for depressed patients.Disclosure of InterestS. Kasper Consultant of: In the past 3 years Dr Kasper served as a consultant or on advisory boards for Angelini, Biogen, Boehringer, Esai, Janssen, IQVIA, Mylan, Recordati, Rovi, and Schwabe; , Speakers bureau of: In the past 3 years Dr. Kasper served on speakers bureaus for Angelini, Aspen Farmaceutica S.A., Biogen, Janssen, Recordati, Schwabe, Servier, and Sothema.

IntroductionHaloperidol (Haldol®) is first-generation antipsychotic that still have a place in the treatment of schizophrenia. However, this molecule is associated with numerous side effects, particularly extrapyramidal symptoms. Edema has been rarely described with haloperidol, and may have an immunoallergic or pharmacodynamic mechanism.ObjectivesOur aim is to study a rare case of facial and limb edema attributed to haloperidol.MethodsWe report the case of a 22-year-old female patient with schizophrenia who developed facial and limb edema after taking haloperidol.ResultsWe report the case of a 22-year-old woman. She was admitted to our psychiatric department “A” as an involuntary inpatient after she threatened to stab her father. She was diagnosed with schizophrenia. The patient has no past medical history. The somatic examination and the admission report were correct.Given the need for a slow-release neuroleptic, the patient was treated with haloperidol in gradually increasing doses up to 30 mg per day.Six weeks after starting treatment, the patient developed progressive edema of the face, eyelids and all 4 limbs, with a marked increase in weight and body mass index from 31 to 36.6.The patient was examined by internists. An etiologic investigation of this edema was initiated, excluding renal origin (strictly normal renal work-up and negative proteinuria), cardiac origin (in view of a negative pro-brain natriuretic peptide, D-dimer and troponins and a normal cardiac echography), hepatic (in the presence of a strictly normal work-up including: protidemia, albuminemia, transaminases, PAL, GGT, bilirubin and prothrombin levels) and endocrine (a normal thyroid work-up) origin.The edema progressively worsened on haloperidol over a period of 10 days. A drug-induced origin was suspected. We contacted the regional pharmacovigilance center in Sfax, which incriminated haloperidol and recommended its immediate discontinuation.After discontinuing the drug, the edema regressed progressively until it disappeared completely after 15 days, confirming that haloperidol was the drug responsible and contraindicating its further use.The responsibility of haloperidol in the genesis of the edema was retained with a plausible score (C2S2I2B3). The scores were calculated according to the French Bégaud method.ConclusionsEdema is not a common side effect of typical antipsychotics, especially haloperidol. However, it is important to emphasize that this effect, although rare, can occur. Clinicians are advised to be aware of edema in all patients taking first or second antipsychotics.Disclosure of InterestNone Declared