Haloperidol

1. Indications
   1. Psychosis
   2. Delirium
   3. Schizophrenia
   4. Tic Disorders (including Tourette's Syndrome)
2. Contraindications
   1. Pregnancy and Lactation
   2. Phencyclidine (PCP) overdose
   3. Anticholinergic syndromes
   4. Alcohol or Benzodiazepine Withdrawal
   5. Hepatic Insufficiency
   6. Neuroleptic Malignant Syndrome
3. Class
   1. First Generation Antipsychotic
4. Dosing: Haloperidol
   1. Dose
      1. Adult: 5-10 mg PO, IM, or IV
      2. Peds: 0.5-1 mg PO, IM or IV
      3. Adolescent: 1-5 mg PO, IM or IV
      4. Elderly: 0.5-2 mg PO, IM or IV
   2. Intervals: Scheduled and repeated dosing intervals
      1. May repeat every 30-60 minutes (maximum: 300 mg/24 hours)
      2. May dose regularly every 6-8 hours
         1. Typical effective dose: 5 mg PO, IV, or IM tid (lower doses in the elderly)
      3. Total dose >3 mg/day is associated with Extrapyramidal Side Effects
5. Precautions
   1. Intravenous doses have a much shorter duration of action than other routes
   2. Antipsychotics are associated with increased mortality in the elderly
6. Dosing: Haloperidol decanoate (depot form)
   1. Haloperidol decanoate 100 mg IM every 4 weeks
   2. Cost effective (may be as low as $19 generic)
7. Adverse effects
   1. See Extrapyramidal Side Effects (EPSE)
   2. Neuroleptic Malignant Syndrome
   3. Hypotension
   4. Dystonia
   5. Prolonged QT interval