Haloperidol (Haldol)

Primer

Haloperidol (Trade name: Haldol) is a first-generation antipsychotic used in the treatment of psychiatric disorders such as schizophrenia.

Pharmacokinetics

See also article: Introduction to Pharmacology

Pharmacokinetics of Haloperidol

Absorption
Distribution
Metabolism
Elimination
Half-life	PO = 12-38hrs, IM (long-acting) = 3 weeks

See also article: Cytochrome (CYP) P450 Metabolism

Haloperidol: Cytochrome P450 Metabolism

Metabolized by
Induces
Inhibits

Pharmacodynamics

Mechanism of Action

Antipsychotics target dopamine receptors (which are in the class of G protein-coupled receptors, or GPCRs)
- Targets dopamine D₂ (nigrostriatal pathway)

Toxicity

Indications

Dosing

Dosing for Haloperidol

Starting	2mg PO
Titration	2mg PO q2weeks
Maximum	15mg PO (max 25mg)
Taper	Slowly over 6-8 weeks

Acute Agitation

See main article: Pharmacological Management of Acute Behavioural Agitation

2-5mg q1h PO/IM (Max 20mg/24hr)

Formulations

Haloperidol comes in oral (PO) or intramuscular (IM) forms

Contraindications

Absolute

Relative

Drug-Drug Interactions

Side Effects

Neuroleptic-induced deficit syndrome
Akathisia
Extrapyramidal symptoms, Parkinsonism, tardive dyskinesia, tardive dystonia
Galactorrhea, amenorrhea
Dizziness, sedation
Dry mouth, constipation, urinary retention, blurred vision
Decreased sweating
Hypotension, tachycardia, hypertension
Weight gain

Adverse Events

Clinical Pearls

Special Populations

Geriatric

See main article: Geriatric Pharmacology

Obstetric and Fetal

See main article: Obstetric and Fetal Pharmacology

Pediatric

See main article: Pediatric Pharmacology

Medically Ill

See main article: Psychotropic Dosing in the Medically Ill

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