Haloperidol

Haloperidol is an antipsychotic medication mainly used to alleviate symptoms associated with

psychotic disorders, such as schizophrenia.

Classification Chemically,
haloperidol is classified as a butyrophenone derivative, which is a group
of compounds that act on the central nervous system to block dopamine
receptors.
Therapeutically,
haloperidol is classified as a first-generation, or typical, antipsychotic
medication. It is primarily used to treat positive symptoms of
schizophrenia, such as delusions, hallucinations, and disordered thinking.
It may also be used to treat other conditions, such as Tourette's
syndrome, severe agitation, and intractable hiccups.
Trade Names of Some international trade names for haloperidol include Haldol, Serenace,
international and Aloperidin, Bioperidolo, Halosten, and Halomonth.
national trade In Oman, haloperidol is available under the trade names Haldol and
name of Halosten, as well as its generic name, haloperidol.
Haloperidol and The generic name and chemical name for haloperidol is "haloperidol"
Generic name And chemical name is
and Chemical "4-[4-(p-chlorophenyl)-4-hydroxypiperidino]-4'-fluorobutyrophenone",
name
Mechanism of Haloperidol acts primarily as a dopamine receptor antagonist in the
Action central nervous system, specifically blocking D2 receptors in the
mesolimbic pathway, which is involved in the regulation of emotions and
reward responses. The inhibition of dopamine receptors by haloperidol
causes a decrease in the activity of dopaminergic neurons, resulting in a
reduction in the positive symptoms of schizophrenia, such as
hallucinations and delusions. In addition to its effects on dopamine
receptors, haloperidol also has some affinity for serotonin receptors,
particularly 5-HT2A receptors. This activity may contribute to its
effectiveness in treating negative symptoms of schizophrenia, such as
apathy and social withdrawal.
Overall, the mechanism of action of haloperidol involves modulation of
neurotransmitter systems in the brain, leading to a reduction in the
symptoms of psychosis and other conditions for which it is prescribed.

Doses, dosage The dosage of haloperidol can vary depending on the individual's
forms, routes of medical condition, age, weight, and other factors, and should be
administration, determined by a healthcare professional. The following are some general
clinical uses and dosing guidelines for haloperidol:
off label use 1. The typical initial dosage for treating schizophrenia is between
0.5 to 2 mg, taken 2-3 times daily. The amount may be gradually
raised over time, with a maximum of 100 mg per day.
2. To address acute agitation or aggression, the starting dose is
usually between 2 to 5 mg, given intravenously (IV) or
intramuscularly (IM) as required. The dose can be repeated every
30-60 minutes, with a maximum of 30 mg daily.
3. To treat Tourette's syndrome, the usual starting dose is 0.5 mg to
2 mg, taken 2-3 times per day. The dose may be gradually
increased to a maximum of 20 mg per day over time.
4. In treating intractable hiccups, the typical starting dose is between
0.5 mg to 2 mg, taken 2-3 times per day. The dose may be
gradually raised up to a maximum of 20 mg per day.
Haloperidol is available in several different dose forms and doses,
including:
Tablets: Haloperidol tablets are available in various strengths ranging
from 0.5 mg to 10 mg. The initial dosage range for adults is commonly
between 0.5 mg to 5 mg, taken 2-3 times per day.
Haloperidol can be administered by several routes, including:
1. Oral: Haloperidol is available as tablets or liquid formulations
that are taken orally. It is recommended to swallow the tablet
whole with water and it can be taken with or without food.
2. Injection: Haloperidol is available in a solution for injection that
can be given either intramuscularly (IM) or intravenously (IV).
The injection is usually given in the deltoid muscle of the upper
arm or in the gluteal muscle of the buttock.
3. Long-acting injection: Haloperidol is also available in a long-
acting injectable form, which is administered as a depot injection
into the muscle every 2-4 weeks.
4. Transdermal patch: Haloperidol is also available as a transdermal
patch, which is applied to the skin and slowly releases the
medication over a 24-hour period.
Solution for injection: Haloperidol is also available in a solution for
injection, which can be administered intramuscularly (IM) or
intravenously (IV). The dose of haloperidol injection may vary
depending on various factors, including the patient's age and weight, the
medical condition being treated, and other relevant factors
Long-acting injection: Haloperidol is also available in a long-acting
injectable form, which is administered as a depot injection every 2-4
 weeks. The dose of the long-acting injection will depend on the
individual's needs and response to treatment.
Haloperidol is primarily used in the treatment of various psychiatric
disorders, including:
1. Schizophrenia: Haloperidol is categorized as a first-generation
antipsychotic medication that is commonly used to address the
positive symptoms of schizophrenia, including delusions and
hallucinations.
2. Acute psychosis: Haloperidol can also be used to manage acute
psychosis, including those due to drug-induced psychosis or as a
result of other medical conditions.
3. Tourette's syndrome: Haloperidol is an effective treatment for the
symptoms of Tourette's syndrome, including tics and
vocalizations.
4. Intractable hiccups: Haloperidol has been shown to be effective in
treating intractable hiccups, which are hiccups that persist for an
extended period and do not respond to conventional treatments.
5. Delirium: Haloperidol can be used to treat delirium, which is a
condition characterized by confusion, agitation, and changes in
consciousness.
In addition to these approved uses, haloperidol may also be used off-label
for the treatment of other conditions, such as anxiety disorders, mood
disorders, and behavioral disturbances in patients with dementia.
However, the use of haloperidol in these situations is less well-
established and should be carefully considered by a healthcare
professional, taking into account the individual's medical history, current
medications, and potential risks and benefits of the treatment.

Side
Effects/Adverse Like all medications, haloperidol may lead to adverse effects or side
effects effects in certain individuals. Some of the frequently observed side
effects linked to haloperidol include:
1. Extrapyramidal symptoms (EPS) are movement disorders that can
occur with the use of antipsychotic medications, including
haloperidol. These symptoms may include tremors, rigidity, and
involuntary movements.
2. Haloperidol can cause sedation, which may impair cognitive and
motor function.
3. Haloperidol may produce anticholinergic effects such as dry
mouth, constipation, and blurred vision.
 4. The usage of haloperidol can result in orthostatic hypotension,
which causes a decline in blood pressure upon standing up,
leading to dizziness or fainting.
5. Haloperidol can affect the body's hormonal balance, causing
changes in menstrual cycles, breast enlargement or discharge, and
sexual dysfunction.
6. Haloperidol may lead to QT prolongation, which can increase the
risk of life-threatening arrhythmias.
7. Neuroleptic malignant syndrome (NMS) is an infrequent but
adverse effect of antipsychotic medications, including
haloperidol. Symptoms may include fever, muscle stiffness, and
altered mental status.
8. Tardive dyskinesia is a movement disorder that may arise after
prolonged use of antipsychotic medications, including
haloperidol. It can be potentially irreversible and symptoms may
include involuntary movements of the face, tongue, and limbs.
9. Haloperidol can cause changes in blood cells, such as decreased
white blood cells and platelets, which can increase the risk of
infections and bleeding (Blood dyscrasias)
It is crucial to acknowledge that not all individuals will experience the
aforementioned side effects, and the intensity and frequency of these side
effects can differ significantly among individuals. If any side effects are
experienced, it is important to inform the healthcare provider
immediately.
Drug-drug or Haloperidol can interact with other medications and foods, leading to
drug-food potentially harmful effects. Some examples of drug-drug and drug-food
interactions interactions with haloperidol include:
1. Haloperidol can enhance the effects of other CNS depressants
such as alcohol, benzodiazepines, and opioids, leading to
increased sedation and respiratory depression.
2. Haloperidol can enhance the anticholinergic effects of other
medications, leading to increased dry mouth, constipation, and
blurred vision.
3. Haloperidol may prolong the QT interval, and the simultaneous
usage of other medications that also prolong the QT interval, such
as some antibiotics and antidepressants, can elevate the risk of
life-threatening arrhythmias.
4. Haloperidol may diminish the effects of levodopa, a medication
employed for treating Parkinson's disease.
5. Grapefruit juice can heighten the blood levels of haloperidol,
 which may augment the probability of side effects.
6. It is critical to notify the healthcare provider about all
medications, supplements, and foods being consumed before
commencing haloperidol therapy, to ensure that there are no
potential interactions.
The healthcare provider may need to adjust the doses of medications or
change the treatment plan to avoid interactions.

Contraindication
s, Precautions Contraindications:
and Counselling 1. Known hypersensitivity or allergy to haloperidol or any of its
points of the components
medication 2. Coma or severe CNS depression
3. Parkinson's disease, dementia with Lewy bodies, or other
neurodegenerative disorders
Precautions:
1. Hepatic or renal impairment
2. Cardiovascular disease, including QT prolongation or arrhythmias
3. History of seizures or conditions that lower the seizure threshold
4. Diabetes mellitus
5. Hypokalemia or hypomagnesemia
6. History of substance abuse or dependence
7. Elderly patients with dementia-related psychosis
Counselling points:
1. Inform the healthcare provider if there is a history of any medical
conditions, especially liver or kidney disease, seizures, or heart
problems.
2. Inform the healthcare provider if taking any other medications or
supplements, as there may be potential drug interactions with
haloperidol.
3. It is recommended to avoid consuming alcohol and central
nervous system (CNS) depressants when taking haloperidol, as it
may raise the chances of sedation and respiratory depression.
4. Haloperidol may cause dizziness or drowsiness, so caution should
be exercised while driving or operating heavy machinery.
5. It may take several weeks for the full effects of haloperidol to be
seen. Do not stop taking the medication without consulting the
healthcare provider.
6. Haloperidol may increase sensitivity to sunlight, so it is important
to use sunscreen and protective clothing while outdoors.
 7. In case of any side effects, inform the healthcare provider
immediately.
8. Haloperidol may cause a decrease in sweating, which can lead to
heat stroke in hot weather. Patients should stay hydrated and
avoid exposure to high temperatures.
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