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August 1992

Sleep in Schizophrenic Patients On and Off Haloperidol Therapy: Clinically 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.

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