III. Dosing: Schizophrenia

  1. Adult with normal hepatic and Renal Function
    1. Start: 40 mg orally daily with food
    2. Typical maintenance dose: 40-160 mg orally daily
    3. Maximum: 160 mg/day
  2. Adult with Moderate to severe hepatic or Renal Function (or strong CYP3A4 Inhibitor)
    1. Start: 20 mg orally daily with food
    2. Maximum: 80 mg/day (40 mg/day if severe hepatic insufficiency)
  3. Child (ages 13 to 17 years old)
    1. Start: 40 mg orally daily with food
    2. Typical maintenance dose: 40-80 mg orally daily
    3. Maximum: 80 mg/day

IV. Dosing: Depression with Bipolar Disorder

  1. Start: 20 mg orally daily with food
  2. Typical maintenance dose: 20 to 60 mg orally daily
  3. Maximum: 120 mg/day (no additional benefit of doses >60 mg)

V. Adverse Effects

  1. Significant CNS depression in Overdose
  2. Hyperlipidemia
  3. Diabetes Mellitus and Hyperglycemia (low risk)
  4. Parkinsonism
  5. Somnolence
  6. Nausea
  7. Extrapyramidal Side Effects (moderate risk)

VI. Safety

  1. Unknown safety in pregnancy and Lactation

VII. Drug Interactions

  1. Metabolized by CYP3A4

IX. References

  1. (2016) Med Lett Drugs Ther 58(1510): 160-5
  2. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 42-3
  3. Hamilton (2020) Tarascon Pocket Pharmacopoeia

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