human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The effectiveness of antipsychotic monotherapy in  schizoaffective disorder  is limited , and further constrained by safety concerns . AIMS We aim ed to compare the efficacy , tolerability and safety profile of the new pharmaceutical , olanzapine , with haloperidol . METHOD Data were assessed from 300 DSM-III-R schizoaffective subjects from a larger double-blind prospect i ve international study . Subjects were r and omly allocated to six weeks of olanzapine ( 5 - 20 mg ) or haloperidol ( 5 - 20 mg ) treatment ; responders were followed for up to one year of double-blind , long-term maintenance therapy . RESULTS Olanzapine-treated patients achieved a statistically significant greater improvement than haloperidol treated patients on overall measures of efficacy , including clinical response . Significantly fewer olanzapine patients left the study early , and fewer adverse events were observed among those receiving olanzapine . During maintenance , olanzapine-treated patients continued to experience additional improvement , with fewer EPS but more weight gain than those on haloperidol . CONCLUSIONS Olanzapine demonstrated substantial advantages over the conventional antipsychotic haloperidol in the management of schizoaffective disorder Zuclopenthixol acetate — a new injectable formulation with a duration of action of 2–3 days — was compared with conventional intramuscular and oral formulations of haloperidol and zuclopenthixol in the initial treatment of acutely disturbed , psychotic patients . The patients were stratified into 3 diagnostic categories : acute psychoses ( 48 patients ) , mania ( 22 patients ) , and exacerbation of chronic psychoses ( 73 patients ) . The patients were rated on the Brief Psychiatric Rating Scale ( BPRS ) , the Bech‐Rafaelsen Mania Rating Scale ( brmas ) ( only manic patients ) and globally on the Clinical Global Impression ( CGI ) . The study was an open , r and omized multicentre trial with a 6‐day treatment period . The zuclopenthixol acetate patients received 1–4 doses , the haloperidol patients 1–26 and the zuclopenthixol patients 1–22 doses . The assessment s on the CGI showed that all 3 treatments caused a clear reduction of the severity of illness scores in all 3 diagnostic categories , with no differences between treatments . The ratings of the acute and chronic psychotic patients on the BPRS also showed significant reductions in scores with no differences between treatments . All 3 treatments caused a rapid remission of symptoms on the BRMAS .  Haloperidol  induced hypokinesia in significantly more patients than zuclopenthixol acetate after 24 h. Later there were no significant differences between treatments . Zuclopenthixol acetate fulfils many desires for an amended neuroleptic formulation for the initial treatment of acutely disturbed psychotic patients Previous investigations of the treatment of mania have result ed in uncertainty about the efficacy of lithium versus a neuroleptic . In addition there have been reports of toxicity with a haloperidol -- lithium combination . In order to determine the comparative efficacy of lithium vs haloperidol vs a combination of haloperidol -- lithium , we studied 21 severely ill manic patients who all met rigorous criteria for bipolar illness and who required in hospital treatment . Subjects were r and omly assigned to 3 groups : ( A ) Lithium plus placebo ( B ) Placebo plus haloperidol and ( C ) Lithium plus haloperidol . The study was conducted in double blind fashion for 3 weeks with the dosages of the medications varied according to clinical response or untoward effects . Subjects on haloperidol and placebo or the haloperidol -- lithium combination were significantly improved after 7 days in comparison to the lithium-treated group . Groups B and C did not differ from each other , either in degree of improvement or in side effects . Inspite of the relatively small sample size the results suggest ( 1 ) that haloperidol is superior to lithium for treating severely ill acute mania and ( 2 ) that while a haloperidol -- lithium combination does not result in a significant increase in side effects , it is not superior to haloperidol alone In this study , the authors examined the relationship between steady-state haloperidol  blood levels and clinical response in patients with acute psychotic mania . Fifty-four in patients with acute mania were r and omly assigned to receive either haloperidol 25 mg/day or haloperidol 5 mg/day . Each subject also received a concomitant medication : lorazepam 4 mg/day , lithium , or placebo . The relationship between steady-state  haloperidol blood levels and clinical improvement was studied using analysis of covariance . There was wide interindividual variation in the  haloperidol blood level – dose ratio . Haloperidol blood levels ( log-transformed ) were found to significantly correlate with clinical response in acute mania . Low-dose haloperidol with concomitant lithium may produce an optimal response in acute mania .  Haloperidol blood levels may be clinical ly useful in identifying patients who are nonresponsive because of low drug levels and , hence , in enhancing optimal haloperidol dosing for acute mania with psychosis Lithium carbonate , haloperidol , and chlorpromazine hydrochloride were compared in a double-blind controlled study with severely ill hospitalized manics .  Lithium carbonate and haloperidol produced a highly significant improvement of manic symptoms without sedation . Although producing considerable sedation , chlorpromazine did little to alter the underlying mania qualitatively . Qualitative differences between lithium carbonate and haloperidol indicate that , while haloperidol has a more dramatically rapid impact on behavior-motor activity , lithium carbonate acted more evenly on the entire manic picture , with total normalization realized during active treatment . The majority of lithium carbonate-treated patients met discharge criteria at study termination , but not the patients receiving either neuroleptic drug . The rating scales are not sensitive enough to monitor manic psychopathology ; this accounts for the lack of statistically significant differences among drug groups at treatment termination , despite the widely disparate discharge rates BACKGROUND This r and omized controlled trial compares the efficacy and safety of olanzapine vs haloperidol , as well as the quality of life of patients taking these drugs , in patients with bipolar mania . METHODS The design consisted of 2 successive , 6-week , double-blind periods and compared flexible dosing of olanzapine ( 5 - 20 mg/d , n = 234 ) with haloperidol ( 3 - 15 mg/d , n = 219 ) . RESULTS Rates of remission ( Young-Mania Rating Scale score of < or = 12 and 21-item Hamilton Rating Scale for Depression score of < or = 8 at week 6 ) were similar for  olanzapine- and haloperidol-treated patients ( 52.1 % vs 46.1 % , respectively ; P = .15 ) . For the subgroup of patients whose index episode did not include psychotic features , rates of remission were significantly greater for the olanzapine group compared with the haloperidol group ( 56.7 % vs 41.6 % , P = .04 ) . Relapse into an affective episode ( mania and /or depression ) occurred in 13.1 % and 14.8 % of olanzapine- and haloperidol-treated patients , respectively ( P = .56 ) . Switch to depression occurred significantly more rapidly with haloperidol than with olanzapine when using survival analysis techniques ( P = .04 ) , and significantly more haloperidol-treated patients experienced worsening of extrapyramidal symptoms , as indicated by several measures . Weight gain was significantly greater in the olanzapine group compared with the haloperidol group ( 2.82 vs 0.02 kg , P<.001 ) . The olanzapine group had significant improvement in quality of life on several dimensions compared with the haloperidol group . CONCLUSIONS These data suggest that olanzapine does not differ from haloperidol in achieving overall remission of bipolar mania . However , haloperidol carries a higher rate of extrapyramidal symptoms , whereas olanzapine is associated with weight gain This double-blind clinical trial studied 16 acutely agitated psychotic patients with manic or manic-like symptoms who needed rapid tranquilization and were therefore on maintenance treatment . They were r and omized to receive intramuscular preparations of clonazepam ( 1 to 2 mg ) or haloperidol ( 5 to 10 mg ) at 0 , 0.5 , and 1.0 hours . Both medications produced significant reduction of manic symptoms within two hours of initial treatment ; however , haloperidol produced beneficial results more rapidly than clonazepam . All patients completed the study , with the exception of one haloperidol-treated patient who developed severe parkinsonism . It was concluded that I.M. clonazepam is an effective , safe , but slower-acting alternative to I.M. haloperidol in the treatment of agitated psychiatric patients in need of rapid tranquilization After 2 days of drug-free observation , 20 newly admitted psychotic patients received 20 - 35 mg of haloperidol intravenously and 20 patients received 30 - 40 mg of diazepam intravenously . Posttreatment ratings at 4 and 24 hours with the Brief Psychiatric Rating Scale and the Clinical Global Impressions revealed significant improvement in both groups but no significant differences between the two treatments BACKGROUND Bipolar affective disorder ( BPAD ) has considerable implication s for personal and social functioning . However a tendency to be over-represented in high socio-economic classes has been reported in earlier studies , suggesting that social disadvantage accompanying the illness is not severe . In addition , an association between affective disorders in general and increased residential mobility has been suggested , but it is unclear if such an association exists with BPAD . OBJECTIVES ( 1 ) To investigate the suggestion made in previous studies that patients with bipolar disorder are advantaged socially . ( 2 ) To test the hypothesis that patients with bipolar disorder show greater residential mobility compared with other patients with psychiatric disorders . METHODS Ninety patients with DSM IV diagnosis of bipolar disorder admitted to the acute in-patient unit of a public-financed district psychiatric service in Dublin were compared with a control group of 91 r and omly selected patients with other psychiatric diagnoses , excluding schizophrenia .  Socio-economic , educational and employment ratings were compared , and also  duration of illness , frequency of admission and residential mobility .  The data were collected retrospectively from case notes and through semistructured interviews with patients or their relatives . The bipolar group was compared with the control group and to the unipolar depression subgroup . RESULTS The bipolar and control groups were found to have similar demographic and socio-economic features , although the bipolar group had more years of education compared with the whole control group but not when compared with the unipolar depression group . The bipolar group showed longer duration of psychiatric disorder , more frequent hospital admissions and more frequent residential moves since the onset of the illness . CONCLUSION Bipolar patients requiring in-patient care in this service experience severe disruption to their lives over prolonged periods The relative efficacy and safety of risperidone versus haloperidol in the treatment of schizoaffective disorder was studied . Sixty-two patients ( 29 depressed type ; 33 bipolar type ) entered a three-site , r and omized , double-blind , 6-week trial of risperidone ( up to 10 mg/day ) or haloperidol ( up to 20 mg/day ) . Trained raters assessed baseline , weekly , and end-of- study levels of psychopathology with the Positive and Negative Syndrome Scale ( PANSS ) , the 24-item Hamilton Rating Scale for Depression ( HAM-D-24 ) and the Clinician-Administered Rating Scale for Mania ( CARS-M ) . The authors were unable to statistically distinguish between risperidone and haloperidol in the amelioration of psychotic and manic symptoms . In addition , there was no difference in worsening of mania between the two agents in either subgroup ( i.e. , depressed or bipolar subgroups ) . For the total PANSS , risperidone produced a mean decrease of 16 points from baseline compared with a 14-point decrease with haloperidol . For the total CARS-M scale , risperidone and haloperidol produced mean change scores of 5 and 8 points , respectively , and for the CARS-M Mania subscale , 3 and 7 points , respectively . Additionally , risperidone produced a mean decrease of 13 points from the baseline 24-item HAM-D , compared with an 8-point decrease with haloperidol . In those patients who had more severe depressive symptoms ( i.e. , HAM-D baseline score > 20 ) , risperidone produced at least a 50 % mean improvement in 12 ( 75 % ) of 16 patients in comparison to 8 ( 38 % ) of 21 patients receiving haloperidol . Haloperidol produced significantly more extrapyramidal side effects and result ed in more dropouts caused by any side effect . There was no difference between risperidone and haloperidol in reducing both psychotic and manic symptoms in this group of patients with schizoaffective disorder .  Risperidone did not demonstrate a propensity to precipitate mania and was better tolerated than haloperidol . In those subjects with higher baseline HAM-D scores ( i.e. , > 20 ) , risperidone produced a greater improvement in depressive symptoms than haloperidol The aim of this study is to evaluate the activity of flupentixol oral high concentration and to define the profile of the drug according to the administered do 
    Output:
    
agent
There is some evidence that haloperidol is an effective treatment for  acute mania .
From the limited data available , there was no difference in overall efficacy of treatment between haloperidol and olanzapine or risperidone .
Some evidence suggests that haloperidol could be less effective than aripiprazole .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The effectiveness of antipsychotic monotherapy in  schizoaffective disorder  is limited , and further constrained by safety concerns . AIMS We aim ed to compare the efficacy , tolerability and safety profile of the new pharmaceutical , olanzapine , with haloperidol . METHOD Data were assessed from 300 DSM-III-R schizoaffective subjects from a larger double-blind prospect i ve international study . Subjects were r and omly allocated to six weeks of olanzapine ( 5 - 20 mg ) or haloperidol ( 5 - 20 mg ) treatment ; responders were followed for up to one year of double-blind , long-term maintenance therapy . RESULTS Olanzapine-treated patients achieved a statistically significant greater improvement than haloperidol treated patients on overall measures of efficacy , including clinical response . Significantly fewer olanzapine patients left the study early , and fewer adverse events were observed among those receiving olanzapine . During maintenance , olanzapine-treated patients continued to experience additional improvement , with fewer EPS but more weight gain than those on haloperidol . CONCLUSIONS Olanzapine demonstrated substantial advantages over the conventional antipsychotic haloperidol in the management of schizoaffective disorder Zuclopenthixol acetate — a new injectable formulation with a duration of action of 2–3 days — was compared with conventional intramuscular and oral formulations of haloperidol and zuclopenthixol in the initial treatment of acutely disturbed , psychotic patients . The patients were stratified into 3 diagnostic categories : acute psychoses ( 48 patients ) , mania ( 22 patients ) , and exacerbation of chronic psychoses ( 73 patients ) . The patients were rated on the Brief Psychiatric Rating Scale ( BPRS ) , the Bech‐Rafaelsen Mania Rating Scale ( brmas ) ( only manic patients ) and globally on the Clinical Global Impression ( CGI ) . The study was an open , r and omized multicentre trial with a 6‐day treatment period . The zuclopenthixol acetate patients received 1–4 doses , the haloperidol patients 1–26 and the zuclopenthixol patients 1–22 doses . The assessment s on the CGI showed that all 3 treatments caused a clear reduction of the severity of illness scores in all 3 diagnostic categories , with no differences between treatments . The ratings of the acute and chronic psychotic patients on the BPRS also showed significant reductions in scores with no differences between treatments . All 3 treatments caused a rapid remission of symptoms on the BRMAS .  Haloperidol  induced hypokinesia in significantly more patients than zuclopenthixol acetate after 24 h. Later there were no significant differences between treatments . Zuclopenthixol acetate fulfils many desires for an amended neuroleptic formulation for the initial treatment of acutely disturbed psychotic patients Previous investigations of the treatment of mania have result ed in uncertainty about the efficacy of lithium versus a neuroleptic . In addition there have been reports of toxicity with a haloperidol -- lithium combination . In order to determine the comparative efficacy of lithium vs haloperidol vs a combination of haloperidol -- lithium , we studied 21 severely ill manic patients who all met rigorous criteria for bipolar illness and who required in hospital treatment . Subjects were r and omly assigned to 3 groups : ( A ) Lithium plus placebo ( B ) Placebo plus haloperidol and ( C ) Lithium plus haloperidol . The study was conducted in double blind fashion for 3 weeks with the dosages of the medications varied according to clinical response or untoward effects . Subjects on haloperidol and placebo or the haloperidol -- lithium combination were significantly improved after 7 days in comparison to the lithium-treated group . Groups B and C did not differ from each other , either in degree of improvement or in side effects . Inspite of the relatively small sample size the results suggest ( 1 ) that haloperidol is superior to lithium for treating severely ill acute mania and ( 2 ) that while a haloperidol -- lithium combination does not result in a significant increase in side effects , it is not superior to haloperidol alone In this study , the authors examined the relationship between steady-state haloperidol  blood levels and clinical response in patients with acute psychotic mania . Fifty-four in patients with acute mania were r and omly assigned to receive either haloperidol 25 mg/day or haloperidol 5 mg/day . Each subject also received a concomitant medication : lorazepam 4 mg/day , lithium , or placebo . The relationship between steady-state  haloperidol blood levels and clinical improvement was studied using analysis of covariance . There was wide interindividual variation in the  haloperidol blood level – dose ratio . Haloperidol blood levels ( log-transformed ) were found to significantly correlate with clinical response in acute mania . Low-dose haloperidol with concomitant lithium may produce an optimal response in acute mania .  Haloperidol blood levels may be clinical ly useful in identifying patients who are nonresponsive because of low drug levels and , hence , in enhancing optimal haloperidol dosing for acute mania with psychosis Lithium carbonate , haloperidol , and chlorpromazine hydrochloride were compared in a double-blind controlled study with severely ill hospitalized manics .  Lithium carbonate and haloperidol produced a highly significant improvement of manic symptoms without sedation . Although producing considerable sedation , chlorpromazine did little to alter the underlying mania qualitatively . Qualitative differences between lithium carbonate and haloperidol indicate that , while haloperidol has a more dramatically rapid impact on behavior-motor activity , lithium carbonate acted more evenly on the entire manic picture , with total normalization realized during active treatment . The majority of lithium carbonate-treated patients met discharge criteria at study termination , but not the patients receiving either neuroleptic drug . The rating scales are not sensitive enough to monitor manic psychopathology ; this accounts for the lack of statistically significant differences among drug groups at treatment termination , despite the widely disparate discharge rates BACKGROUND This r and omized controlled trial compares the efficacy and safety of olanzapine vs haloperidol , as well as the quality of life of patients taking these drugs , in patients with bipolar mania . METHODS The design consisted of 2 successive , 6-week , double-blind periods and compared flexible dosing of olanzapine ( 5 - 20 mg/d , n = 234 ) with haloperidol ( 3 - 15 mg/d , n = 219 ) . RESULTS Rates of remission ( Young-Mania Rating Scale score of < or = 12 and 21-item Hamilton Rating Scale for Depression score of < or = 8 at week 6 ) were similar for  olanzapine- and haloperidol-treated patients ( 52.1 % vs 46.1 % , respectively ; P = .15 ) . For the subgroup of patients whose index episode did not include psychotic features , rates of remission were significantly greater for the olanzapine group compared with the haloperidol group ( 56.7 % vs 41.6 % , P = .04 ) . Relapse into an affective episode ( mania and /or depression ) occurred in 13.1 % and 14.8 % of olanzapine- and haloperidol-treated patients , respectively ( P = .56 ) . Switch to depression occurred significantly more rapidly with haloperidol than with olanzapine when using survival analysis techniques ( P = .04 ) , and significantly more haloperidol-treated patients experienced worsening of extrapyramidal symptoms , as indicated by several measures . Weight gain was significantly greater in the olanzapine group compared with the haloperidol group ( 2.82 vs 0.02 kg , P<.001 ) . The olanzapine group had significant improvement in quality of life on several dimensions compared with the haloperidol group . CONCLUSIONS These data suggest that olanzapine does not differ from haloperidol in achieving overall remission of bipolar mania . However , haloperidol carries a higher rate of extrapyramidal symptoms , whereas olanzapine is associated with weight gain This double-blind clinical trial studied 16 acutely agitated psychotic patients with manic or manic-like symptoms who needed rapid tranquilization and were therefore on maintenance treatment . They were r and omized to receive intramuscular preparations of clonazepam ( 1 to 2 mg ) or haloperidol ( 5 to 10 mg ) at 0 , 0.5 , and 1.0 hours . Both medications produced significant reduction of manic symptoms within two hours of initial treatment ; however , haloperidol produced beneficial results more rapidly than clonazepam . All patients completed the study , with the exception of one haloperidol-treated patient who developed severe parkinsonism . It was concluded that I.M. clonazepam is an effective , safe , but slower-acting alternative to I.M. haloperidol in the treatment of agitated psychiatric patients in need of rapid tranquilization After 2 days of drug-free observation , 20 newly admitted psychotic patients received 20 - 35 mg of haloperidol intravenously and 20 patients received 30 - 40 mg of diazepam intravenously . Posttreatment ratings at 4 and 24 hours with the Brief Psychiatric Rating Scale and the Clinical Global Impressions revealed significant improvement in both groups but no significant differences between the two treatments BACKGROUND Bipolar affective disorder ( BPAD ) has considerable implication s for personal and social functioning . However a tendency to be over-represented in high socio-economic classes has been reported in earlier studies , suggesting that social disadvantage accompanying the illness is not severe . In addition , an association between affective disorders in general and increased residential mobility has been suggested , but it is unclear if such an association exists with BPAD . OBJECTIVES ( 1 ) To investigate the suggestion made in previous studies that patients with bipolar disorder are advantaged socially . ( 2 ) To test the hypothesis that patients with bipolar disorder show greater residential mobility compared with other patients with psychiatric disorders . METHODS Ninety patients with DSM IV diagnosis of bipolar disorder admitted to the acute in-patient unit of a public-financed district psychiatric service in Dublin were compared with a control group of 91 r and omly selected patients with other psychiatric diagnoses , excluding schizophrenia .  Socio-economic , educational and employment ratings were compared , and also  duration of illness , frequency of admission and residential mobility .  The data were collected retrospectively from case notes and through semistructured interviews with patients or their relatives . The bipolar group was compared with the control group and to the unipolar depression subgroup . RESULTS The bipolar and control groups were found to have similar demographic and socio-economic features , although the bipolar group had more years of education compared with the whole control group but not when compared with the unipolar depression group . The bipolar group showed longer duration of psychiatric disorder , more frequent hospital admissions and more frequent residential moves since the onset of the illness . CONCLUSION Bipolar patients requiring in-patient care in this service experience severe disruption to their lives over prolonged periods The relative efficacy and safety of risperidone versus haloperidol in the treatment of schizoaffective disorder was studied . Sixty-two patients ( 29 depressed type ; 33 bipolar type ) entered a three-site , r and omized , double-blind , 6-week trial of risperidone ( up to 10 mg/day ) or haloperidol ( up to 20 mg/day ) . Trained raters assessed baseline , weekly , and end-of- study levels of psychopathology with the Positive and Negative Syndrome Scale ( PANSS ) , the 24-item Hamilton Rating Scale for Depression ( HAM-D-24 ) and the Clinician-Administered Rating Scale for Mania ( CARS-M ) . The authors were unable to statistically distinguish between risperidone and haloperidol in the amelioration of psychotic and manic symptoms . In addition , there was no difference in worsening of mania between the two agents in either subgroup ( i.e. , depressed or bipolar subgroups ) . For the total PANSS , risperidone produced a mean decrease of 16 points from baseline compared with a 14-point decrease with haloperidol . For the total CARS-M scale , risperidone and haloperidol produced mean change scores of 5 and 8 points , respectively , and for the CARS-M Mania subscale , 3 and 7 points , respectively . Additionally , risperidone produced a mean decrease of 13 points from the baseline 24-item HAM-D , compared with an 8-point decrease with haloperidol . In those patients who had more severe depressive symptoms ( i.e. , HAM-D baseline score > 20 ) , risperidone produced at least a 50 % mean improvement in 12 ( 75 % ) of 16 patients in comparison to 8 ( 38 % ) of 21 patients receiving haloperidol . Haloperidol produced significantly more extrapyramidal side effects and result ed in more dropouts caused by any side effect . There was no difference between risperidone and haloperidol in reducing both psychotic and manic symptoms in this group of patients with schizoaffective disorder .  Risperidone did not demonstrate a propensity to precipitate mania and was better tolerated than haloperidol . In those subjects with higher baseline HAM-D scores ( i.e. , > 20 ) , risperidone produced a greater improvement in depressive symptoms than haloperidol The aim of this study is to evaluate the activity of flupentixol oral high concentration and to define the profile of the drug according to the administered do 
    Output:
    