The Editor in Chief of Current Psychiatry, Dr. Henry Nasrallah, MD, deleted his editorial on "Haloperidol clearly is neurotoxic. Should it be banned?"
References to the article can be found on the web:
Dr. Nasrallah writes:
Haloperidol Clearly Is Neurotoxic. Should It Be Banned?
Article from: Current Psychiatry | July 1, 2013 | Nasrallah, Henry A. | Copyright
"Why use an old and harmful antipsychotic when safer alternatives are available?
Few medications remain in use 50 years after they were launched. Advances in drug development often render older drugs obsolete because newer drugs are more efficacious or safer, or both. Consider reserpine: Nowadays, no internist would use this drug to treat hypertension, even though it was the top-selling antihypertensive 50 years ago. Why? The adverse effects profile is no longer acceptable, with safer alternatives available.
Astonishingly, almost all first-generation psychotropics discovered 5 decades ago (neuroleptics, tricyclic antidepressants, monoamine oxidase inhibitors) are still on the formularies of most health care facilities and are used by many clinicians, especially those working with managed care organizations. Jails and prisons in the United States, where hundreds of thousands of seriously mentally ill patients are incarcerated, also use 50-year-old agents, without regard to the downside of older drugs on …"
Are The Second Generation Neuroleptics Good For the Brain?
by PHIL on AUGUST 5, 2013
"There’s an editorial by Henry Nasrallah, MD, in last month’s edition of Current Psychiatry. Dr. Nasrallah is the journal’s editor-in-chief. The title of the article is Haloperidol clearly is neurotoxic. Should it be banned? Haloperidol is marketed under the brand name Haldol, but its patent has long expired, and a generic version is available and inexpensive.
Here’s a quote from Dr. Nasrallah’s article:
“If clinicians who use these decades old drugs were to keep up with medical research and advances in knowledge, we would realize what a travesty it is to use a brain-unfriendly drug such as haloperidol when we have many safer alternatives. A massive volume of knowledge has emerged over the past 15 years about the neurotoxicity of older neuroleptics, especially haloperidol—knowledge that was completely unknown before. Second-generation antipsychotics have been shown to be much safer for the brain than their older-generation counterparts (although they are not more efficacious).”
This was a powerful and unequivocal editorial. Dr. Nasrallah writes,
“The FDA would never approve haloperidol today, given the serious harm it can do to the brain, despite its efficacy for psychosis. (It’s interesting how the FDA bans a drug immediately if it causes tragic birth defects, such as thalidomide, but not if a drug is destructive to the brain tissue of a disabled adult patient.)”
Why did he delete his article? We don't know why he deleted the article but we know why he wrote it. PHILIP HICKEY, PH.D. says the newer drugs are not safer but much more expensive.
"A 30-day supply of haloperidol tablets (5 mg per day) costs about $4. A 30-day supply of aripiprazole tablets (10mg per day) costs about $1424. [GoodRx]"
"Could it be – could it possibly be – that the real problem with haloperidol is not its neurotoxicity (which apparently didn’t bother Dr. Nasrallah too much in the old days), but rather its price? It’s too cheap! Every time a psychiatrist writes a prescription for haloperidol, it’s $1420 down the drain."