Haloperidol

Introduction: Haloperidol is a prescription medicine used in the treatment of schizophrenia (a mental disorder in which a person develops unreal thoughts and behavior). It is also used to treat Tourette syndrome, psychosis, mania and severe behavioral problems.

How it works: Haloperidol blocks postsynaptic dopamine D1 and D2 receptors in the mesolimbic system and decreases the release of hypothalamic and hypophyseal hormones. It produces calmness and reduces aggressiveness with disappearance of hallucinations and delusions.

Important Information: This medicine may be taken with or without food, preferably at the same time each day. Do not stop suddenly without talking to your doctor as it may worsen your symptoms.

• Low doses: nervousness, anxiety states and associated psychic disorders (irritability, aggressiveness, psychic lability, insomnia); functional disorders caused by anxiety states (trembling, thorax oppression, gastrointestinal hypermotility, digestive disorders); tics and stuttering; nausea and vomiting
• Higher doses: psychomotor agitation in mania, dementia, acute and chronic schizophrenia, alcoholism; delusions and hallucinations in acute and chronic schizophrenia, acute confusion; choreatic movements; behavior and character disorders in children

Butyrophenone drugs, Drugs used in tremor, tics & related disorder

Typical Antipsychotic

Haloperidol is a butyropherone derivative with antipsychotic properties that has been considered particularly effective in the management of hyperactivity, agitation and mania. Haloperidol is an effective neuroleptic and also possesses antiemetic properties. It may also exhibit hypothermic and anorexiant effects and potentiate the action of barbiturates, general anesthetics and other CNS depressant drugs.

Haloperidol blocks dopamine receptors in the brain to control psychotic symptoms and produce calmness.

Adults (Oral):

• Moderate symptoms: 0.5-3 mg 2-3 times daily
• Severe symptoms: 3-5 mg 2-3 times daily
• Chronic or resistant: 3-6 mg 2-3 times daily
• Up to 100 mg daily if needed
• Elderly: 0.5-4.5 mg 2-3 times daily

Children: 50 microgram/kg body weight

Injection (IM/IV):

• Initially 2-10 mg, then every 4-8 hours, max 18 mg daily
• Severely disturbed patients: initial up to 18 mg

* Use as directed by the registered physician

Oral tablet or injection (IM/IV). Can be taken with or without food. Swallow whole, do not chew or crush.

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and follow your regular schedule. Do not double the dose.

Common Side Effects:

• Abnormality of voluntary movements
• Constipation
• Dryness in mouth
• Increased prolactin level in blood
• Orthostatic hypotension
• Sleepiness
• Weight gain
• Headache
• Vertigo
• Insomnia
• Confusion
• Restlessness
• Anxiety

Precautions:

• Haloperidol may decrease alertness and affect vision - do not drive
• Avoid alcohol (increases dizziness)
• Inform doctor if you experience abnormal movements or difficulty controlling movements
• Avoid dehydration - drink plenty of fluids
• Heart function and electrolyte levels should be monitored
• Caution in severe liver or kidney disease

Contraindications:

• Severe toxic CNS depression
• Preexisting coma
• Parkinson's disease
• Lactation

Drug Interactions:

• Carbamazepine and rifampicin reduce plasma concentrations
• CNS depressants (alcohol, hypnotics, general anaesthetics, opioids) enhance effects
• Reduces antihypertensive action of guanethidine
• Increased risk of arrhythmia with drugs that prolong QT interval
• Increases lithium blood levels

Food Interactions:

• Alcohol may cause excessive drowsiness

Use in Pregnancy: May be unsafe during pregnancy. Animal studies have shown harmful effects.

Use in Lactation: Probably unsafe during breastfeeding. Limited data suggests the drug may pass into breastmilk and harm the baby. Haloperidol is excreted in breast milk.

Pediatric Use: Dosage available for children 3-12 years (behavioral disorders and Tourette disorder).

Geriatric Use: Lower initial doses and more gradual adjustments recommended. Start with 0.25-0.5 mg every 8-12 hours.

Renal Impairment: Safe in kidney disease (no dose adjustment needed), but start with lower dose in severe kidney disease.

Hepatic Impairment: Use with caution in liver disease. Dose adjustment may be needed.

Overdose: Severe extrapyramidal reactions, hypotension or sedation, respiratory depression, coma. Symptomatic and supportive treatment should be given.

Storage: Do not store above 30°C. Keep away from light and out of reach of children.

Haloperidol