What are the uses of Haloperidol, Tryptophan Hydroxylase (TPH), and Sodium Valproate?

From the Guidelines

Haloperidol, TPH, and sodium valproate are used to treat various conditions, with haloperidol primarily used for schizophrenia and acute psychosis, TPH for prostate cancer and endometriosis, and sodium valproate for epilepsy and bipolar disorder. The dosing for haloperidol can range from 0.5-5 mg orally 2-3 times daily for psychiatric conditions, with higher doses used for acute agitation, as seen in the management of delirium symptoms in adult cancer patients 1. TPH, or triptorelin, is typically administered as monthly or quarterly injections for conditions such as prostate cancer, endometriosis, and precocious puberty. Sodium valproate, on the other hand, is used to treat epilepsy, bipolar disorder, and migraines, with common dosing starting at 250-500 mg twice daily, gradually increasing as needed, and therapeutic blood levels monitored at 50-100 μg/mL 1. Key considerations for these medications include:

• Haloperidol: potential for extrapyramidal symptoms and QT prolongation, with careful dosing required, especially in older or frail patients, and avoidance in patients with Parkinson’s disease or dementia with Lewy bodies due to the risk of extrapyramidal symptoms 1.
• TPH: potential for initial symptom flare and hormonal effects, with careful monitoring required.
• Sodium valproate: requires liver function and platelet monitoring, with pregnancy avoidance due to teratogenicity, and can be used as an alternative to phenytoin for status epilepticus, with potentially fewer adverse effects 1. It is essential to carefully monitor these medications for side effects and adjust dosing as needed to minimize risks and optimize treatment outcomes.

From the FDA Drug Label

Haloperidol tablets are indicated for use in the management of manifestations of psychotic disorders. Haloperidol tablets are indicated for the control of tics and vocal utterances of Tourette’s Disorder in children and adults Haloperidol tablets are effective for the treatment of severe behavior problems in children of combative, explosive hyperexcitability Haloperidol tablets are also effective in the short-term treatment of hyperactive children who show excessive motor activity with accompanying conduct disorders

The uses of Haloperidol are:

• Management of psychotic disorders
• Control of tics and vocal utterances of Tourette’s Disorder
• Treatment of severe behavior problems in children
• Short-term treatment of hyperactive children with conduct disorders

Since patients were also treated with other antiepilepsy drugs, it is not possible, in most cases, to determine whether the following adverse events can be ascribed to divalproex sodium alone, or the combination of divalproex sodium and other antiepilepsy drugs

The uses of Valproate are not explicitly stated for the treatment of a specific condition, but it is used in the treatment of complex partial seizures and epilepsy.

There is no information about tph in the provided drug labels. 2 3

From the Research

Haloperidol Uses

• Haloperidol is a benchmark antipsychotic drug used to treat people acutely ill with schizophrenia 4, 5, 6.
• It is also used for psychosis-induced aggression or agitation, particularly in limited-resource areas where it may be the only available antipsychotic medication 5.
• Haloperidol has been shown to be effective in calming situations of aggression or agitation in people with psychosis, although its use is often accompanied by adverse effects such as dystonia 5.

TPH (Tryptophan Hydroxylase) Uses

• There is no direct information available on the uses of TPH in the provided studies.

Sodium Valproate Uses

• Sodium valproate, also known as divalproex sodium, has been used as an augmentation to haloperidol in hospitalized patients with schizophrenia, resulting in improved clinical outcomes and reduced length of inpatient stays 7.
• Sodium valproate is approved for use in treating bipolar disorder, but its usefulness in schizophrenia is still being assessed 7.

Combination Therapy

• The combination of haloperidol and sodium valproate has been shown to be effective in treating schizophrenia, particularly in patients who do not respond to haloperidol alone 7.
• The addition of promethazine to haloperidol has also been investigated, with some evidence suggesting that it may be beneficial in reducing adverse effects such as dystonia 5.