Generic Name: Haloperidol
Product Name: Serenace
Haloperidol is used in the management of psychotic symptoms due to diseases such as:
- psychosis due to brain damage or mental deficiency
- senile psychosis
- manic phase of manic depressive illness
- Tourette syndrome
It can also be used in the acute management of alcoholism to control:
- confused states
- aggressive behaviour
Haloperidol can also be used to treat intractable nausea and vomiting associated with radiation or malignancy.
When used in combination with a narcotic analgesia, Haloperidol may be used to achieve a state of neuroleptanalgesia.
Haloperidol is a drug that has the capability to affect the mental state. Its precise mechanism of action is unknown, but it acts on the neurotransmitter (chemical messenger) dopamine in the brain. It blocks dopamine receptors and causes an increased turnover of dopamine in the brain, which has a sedative effect. With medium-term administration, it causes decreased release of dopamine and this, combined with the dopamine receptor blockade, leads to the antipsychotic effect of Haloperidol. Haloperidol also blocks dopamine receptors in other areas of the brain, which may lead to certain physical side effects (tremor, slow movements, alteration in muscle tone) and altered release of some hormones.
When large doses, IV doses, rapid control of an acutely disturbed patient or heavier than usual doses are required, the patient should be transferred as soon as possible to a place where resuscitation equipment and antiparkinsonian measures are available. There is considerable variation between patients. Careful dose titration according to clinical response is required and will be different for every patient.
Agitation and aggressiveness associated with acute psychosis:
- 2-10mg IM or IV initially
- dose depends on age, weight and severity of symptoms
- initial dose may be given slowly or as a bolus
- subsequent doses should be given half hourly (IV) or hourly (IM) according to response
- the maximum daily dose is 100mgTotal daily maintenance dose:
- once symptoms have been controlled, a maintenance dose should be calculated.
- the half-life of Haloperidol is 24 hours.
- maintenance dose is usually half the daily dose required to achieve initial control of symptoms.
- dose should be divided and given morning and evening.
- transfer to oral therapy should occur as soon as practicableOral administration.
- moderate symptoms: 1-5mg/day
- severe symptoms: 5-10mg/day
- daily doses should be titrated against response and may be as high as 100mg
Elderly and debilitated
- 1-3mg/day is usually sufficient
Haloperidol is only appropriate for severely aggressive or hostile children, or for the treatment of Tourette syndrome.
- 1-3mg/day (use liquid 10-30 drops)
- maintenance dose is usually 0.05mg/kg/day
Common side effects
Common side effects of Haloperidol include:
- postural hypotension (lightheadedness on standing)
- increased heart rate
- dry mouth
- blurred vision
- pupil constriction
- urinary retention
- sexual adverse effects
- weight gain
- increase in blood sugar
Haloperidol often causes effects known as extrapyramidal side effects. These are similar to some of the early symptoms of Parkinson’s disease, and are usually reversible on cessation of treatment.
The symptoms include:
- muscle tremors
- increased or decreased muscle tone (which can cause laryngeal spasm or bronchospasm)
- involuntary movements
- mask-like face
Haloperidol may also cause an increase in serum prolactin levels, which can result in symptoms such as:
- breast development in males
- increased milk production and leaking from nipples
- cessation of menstrual periods
- infertilityall of which are reversible on cessation of therapy.
Uncommon side effects
Less common effects seen with Haloperidol include:
- allergic reactions
- changes in pigmentation of skin or eyes
- opacification of cornea or lens
- fluid retention
- Heatstroke may develop due to a decreased ability to sweat and results in hot, dry skin, muscle weakness and confusion.
For further information talk to your doctor.