What are common typical antipsychotics used in a college student health center, such as Haloperidol (Haldol), Perphenazine (Generic), and Chlorpromazine (Thorazine)?

From the Guidelines

Three common typical antipsychotics used in a college student health center are haloperidol, thioridazine, and chlorpromazine. These medications are primarily prescribed for conditions like schizophrenia, acute psychosis, or severe agitation.

• Haloperidol is often started at 0.5-2 mg once or twice daily
• Thioridazine at 25-100 mg three to four times daily
• Chlorpromazine at 10-50 mg three to four times daily. These medications work by blocking dopamine D2 receptors in the brain, which helps reduce psychotic symptoms like hallucinations and delusions 1. College health centers typically use these medications for short-term crisis management while arranging more comprehensive psychiatric care. It's essential to note that these medications carry risks of significant side effects, including extrapyramidal symptoms (muscle stiffness, tremor), sedation, and metabolic changes, as well as anticholinergic side effects such as sedation and potential deficits in memory 1. Regular monitoring for these side effects is crucial, and these medications are generally not first-line treatments for most college students due to their side effect profile. Newer atypical antipsychotics are often preferred in contemporary practice, but these typical antipsychotics remain important options in certain clinical situations, particularly when the patient's history of medication response and potential side effects are considered 1.

From the FDA Drug Label

Haloperidol tablets are indicated for use in the management of manifestations of psychotic disorders. The three common typical antipsychotics are not listed in the provided drug label. However, Haloperidol is mentioned as one of the typical antipsychotics used in the management of manifestations of psychotic disorders 2.

• Other typical antipsychotics that may be used in a similar context are not specified in the label. The FDA drug label does not answer the question.

From the Research

Typical Antipsychotics Used in a College Student Health Center

• Haloperidol: This is a high-potency typical antipsychotic that is commonly used to treat schizophrenia and other psychotic disorders 3, 4, 5, 6.
• Chlorpromazine: This is a low-potency typical antipsychotic that is also used to treat schizophrenia and other psychotic disorders 3, 4, 5, 6.
• Fluphenazine: This is another high-potency typical antipsychotic that is used to treat schizophrenia and other psychotic disorders 4, 6.

Characteristics of These Antipsychotics

• Haloperidol and fluphenazine are associated with a higher risk of extrapyramidal symptoms, such as acute dystonic reactions, akathisia, tardive dyskinesia, and parkinsonism 3, 4, 5.
• Chlorpromazine is associated with a higher risk of orthostatic hypotension, sedation, and anticholinergic effects 3, 4, 5.
• The choice of antipsychotic depends on the patient's response to the medication and their tolerance of adverse effects 3, 4.