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August 1992

Sleep in Schizophrenic Patients On and Off Haloperidol TherapyClinically Stable vs Relapsed Patients

Author Affiliations

From Highland Drive Veterans Affairs Medical Center, Pittsburgh, Pa (Drs Neylan, van Kammen, and Peters and Ms Kelley); Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine (Drs Neylan, van Kammen, and Peters); and California Pacific Medical Center, San Francisco (Dr Neylan).

Arch Gen Psychiatry. 1992;49(8):643-649. doi:10.1001/archpsyc.1992.01820080051008

• We examined the state-dependent contribution of neuroleptic withdrawal and psychotic relapse in influencing sleep measures. Eighteen clinically stable male schizophrenic patients taking haloperidol were studied with 3 nights of polysomnography for baseline measures and again after neuroleptic withdrawal. Sleep measures were also obtained at the point of relapse (n=9) or after a 6-week drug-free period if the patient remained clinically stable (n=9). Neuroleptic withdrawal led to a global deterioration of rapid eye movement and non—rapid eye movement sleep and a reduction of rapid eye movement latency in both groups. Relapsers differed from nonrelapsers in that they had a larger decrease in total sleep time, sleep efficiency, total non—rapid eye movement sleep, and stage 2 sleep. The level of psychosis was inversely correlated with sleep efficiency, total sleep time, and stage 4 sleep in the drug-free patients. Our data suggest that clinical state needs to be identified in sleep studies of drug-free patients.