Antipsychotic agents haloperidol

Cocaine and other CNS stimulants Monitor cardiac function Lorazepam 2-4 mg IM every 30 minutes to 6 hours as needed for agitation Haloperidol 2-5 mg (or other antipsychotic agent) every 30 minutes to 6 hours as needed for psychotic behavior B2 B3... 

Delusions/Psychosis. Demented patients who are acutely psychotic and agitated should be treated in much the same manner as demented patients with delirium. Low doses of a high potency conventional antipsychotic like haloperidol were once preferred. This was mainly because it can be given both orally and by injection. In recent years, the atypical antipsychotic ziprasidone, which is now also available in oral and injectable forms, has superseded haloperidol as the preferred agent when treating the acutely psychotic and agitated patient with dementia. As previously noted, ziprasidone affords the same tranquilizing benefit as haloperidol, it can now be administered via injection when necessary, and it avoids the problematic extrapyramidal symptoms of haloperidol to which patients with dementia are often keenly sensitive. 

A number of different compounds of the piperidine and piperazine series with p-fluorobuty-rophenone group substitutions at the nitrogen atom display significant neuroleptic activity (haloperidol, trifluperidol, droperidol, methorin). There is a considerable interest in butyrophenone derivatives as antipsychotic agents as well as in anesthesiology. They exhibit pharmacological effects and a mechanism of action very similar to that of phenothiazines and thioxanthenes in that they block dopaminergic receptors. However, they are more selective with respect to D2 receptors. 

Aggravation of the extrapyramidal effects of antipsychotic agents have been described and it has been reported that the use of lithium in combination with haloperidol may result in irreversible neurological toxicity. Lithium can increase the hypothyroid effects of antithyroid agents or iodides. 

A variety of relatively uncommon dermatological side effects have been noted to be associated with antipsychotic agents. These include maculopapular rashes, urticaria, and erythema multiforme (Arana, 2000). Photosensitivity and skin pigmentation can also occur during treatment with these drugs. Although skin pigmentation has been most frequently reported with chlorpromazine, this can occur with thioridazine and trifluoperazine (Harth and Rapoport, 1996). In addition, treatment-induced alopecia has been reported for haloperidol, olanzapine, and risperidone (Mercke et ah, 2000). 

Antipsychotic agents Chlorpromazine (phenothiazine) Haloperidol (butyrophenone)... 

Antipsychotic agents, such as phenothiazines and haloperidol, have been extensively used in the elderly for the management of psychiatric disorders. These are useful in the treatment of schizophrenia and dementia, agitation, and paranoid syndrome. 

Q10 Haloperidol is an antipsychotic or neuroleptic agent. It is an antagonist at dopamine receptors, particularly of the D2 subtype. These drugs help to control the symptoms (mainly the positive symptoms) of schizophrenia by antagonizing the dopamine receptors in different brain areas, such as the frontal and temporal lobes. Antipsychotic agents, such as haloperidol, take days or weeks to achieve their therapeutic effect and may produce some motor disturbances. 

Since the potency (therapeutic efficacy in relation to weight) of antipsychotic agents varies markedly between compounds, it is useful to think of the effective antipsychotic dose of classical agents in terms of chlorpromazine equivalents (see Table 19.5). For example, haloperidol has a relatively high anh-psychotic potency, such that 2-3 mg is equivalent to chlorpromazine 100 mg, whereas sulpiride 200 mg (low potency) is required for the same antipsychotic effect. 

Patients who are neuroleptic naive (i.e. have never previously taken any antipsychotic agent) should start at the lowest available dosage, such as haloperidol 0.5 mg/day or chlorpromazine 25 mg/ day, in case the patient is particularly susceptible to adverse effects, especially extrapyramidal motor... 

The CNS stimulants methylphenidate and dexamfetamine are drugs of choice for attention deficit/hyperactivity disorder. Second line treatment options include clonidine and the antipsychotic agents risperidone, haloperidol and sulpiride. 

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