Haloperidol (Haldol®) is an antipsychotic drug commonly used to treat schizophrenia and other mental health issues. Compliance to haloperidol prescription is poor, with schizophrenia patients reported at 19% adherent and overall patient adherence at about 63%. The current method for monitoring haloperidol usage involves monitoring haloperidol itself. The drug is reported to be present in urine at less than 1%, along with one or more metabolites present in very low levels. Haldol® is also reported to have no glucuronidation of the parent drug. Monitoring Haldol® usage with such low levels of haloperidol and its metabolites heightens the possibility of obtaining false negatives for patients prescribed haloperidol. The attainment of false negatives can misguide a physician to make an unnecessary or unsafe change in a patient’s prescription.
Though haloperidol has previously been reported to remain unconjugated after metabolism, this study has proven that it is in fact glucuronidated and that performing hydrolysis on patient samples prior to an analysis with LC/QTOF significantly increases true positivity.
Independent technical poster presented by Erin C. Strickland – Ameritox, Ltd. at MSACL 2016