- Last edited on March 4, 2021
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