From the Guidelines
Haloperidol is a conventional antipsychotic that can be used as effective monotherapy for the initial drug treatment of the acutely agitated undifferentiated patient in the emergency department. It is a first-generation antipsychotic medication primarily used to treat schizophrenia, acute psychosis, delirium, severe agitation, and Tourette syndrome. According to the Annals of Emergency Medicine study 1, haloperidol can be used as a first-line treatment for acute agitation. The study recommends using a benzodiazepine or a conventional antipsychotic, such as haloperidol, as effective monotherapy for the initial drug treatment of the acutely agitated undifferentiated patient in the ED. Some key points to consider when using haloperidol include:
- Typical dosing ranges from 0.5-5 mg once or twice daily for most psychiatric conditions
- For acute agitation, 2-10 mg may be given intramuscularly
- Common side effects include extrapyramidal symptoms, sedation, and anticholinergic effects
- More serious concerns include tardive dyskinesia, QT prolongation, and neuroleptic malignant syndrome It's essential to regularly monitor patients for side effects and use the lowest effective dose to minimize the risk of adverse effects, as recommended by the study 1.
From the FDA Drug Label
Haloperidol is the first of the butyrophenone series of major tranquilizers. The chemical designation is 4-[4-(p-chloro-phenyl)-4-hydroxypiperidino]-4’—fluorobutyrophenone Haloperidol is a major tranquilizer of the butyrophenone series 2 2.
- It is used for the management of psychotic disorders
- It is also used for the control of tics and vocal utterances of Tourette’s Disorder
- The chemical designation of haloperidol is 4-[4-(p-chloro-phenyl)-4-hydroxypiperidino]-4’—fluorobutyrophenone
From the Research
Definition and Uses of Haloperidol
- Haloperidol is an antipsychotic medication used to treat psychotic agitation in patients with schizophrenia spectrum disorders 3, 4.
- It is also used to manage aggressive behavior and hostility in patients with acute psychosis 4.
- Haloperidol has been compared to other antipsychotic medications, such as risperidone, olanzapine, and quetiapine, in terms of its effectiveness and tolerability 3, 4, 5.
Efficacy and Safety of Haloperidol
- Studies have shown that haloperidol is effective in reducing psychotic agitation and improving symptoms of schizophrenia 3, 5.
- However, it has been associated with a higher risk of extrapyramidal symptoms, such as tremors and rigidity, compared to other antipsychotic medications 4, 5.
- Haloperidol has been found to be as effective as other antipsychotic medications, such as olanzapine and risperidone, in the treatment of psychotic agitation, but with a different side effect profile 3, 4.
Comparison with Other Antipsychotic Medications
- Haloperidol has been compared to risperidone, olanzapine, and quetiapine in several studies, with varying results 3, 4, 5.
- Risperidone has been found to be more effective than haloperidol in reducing symptoms of schizophrenia and anxiety 5.
- Olanzapine and quetiapine have been found to be as effective as haloperidol in reducing psychotic agitation, but with a better tolerability profile 4.