Haloperidol (Haldol)

• Type of Drug: Butyrophenone antipsychotic
• Prescribed for: Psychotic disorders (including Gilles de la Tourette’s syndrome, sometimes used together with nicotine gum), severe behavioral problems in children, short-term treatment of hyperactive children, chronic schizophrenia, vomiting, treatment of acute psychiatric situations, PCP (phencyclidine) psychosis.

Haloperidol General Information

Haloperidol is one of many nonphenothiazine agents used in the treatment of psychosis. These drugs are generally equally effective when given in therapeutically equivalent doses. The major differences are in type and severity of side effects. Some people may respond well to one and not at all to another; this variability is not easily explained and is thought to result from inborn biochemical differences.

Haloperidol acts on a portion of the brain called the hypothalamus. It affects parts of the hypothalamus that control metabolism, body temperature, alertness, muscle tone, hormone balance, and vomiting and may be used to treat problems related to any of these functions. Haloperidol is available in liquid form for those who have trouble swallowing tablets.

Haloperidol Cautions and Warnings

Haloperidol should not be used by people who are allergic to it. Those with very low blood pressure, Parkinson’s disease, or blood, liver, or kidney disease should avoid this drug.

If you have glaucoma, epilepsy, ulcers, or difficulty passing urine, Haloperidol should be used with caution and under strict supervision of your doctor.

Avoid exposure to extreme heat because this drug can upset your body’s normal temperature-control mechanism.

Possible Side Effects

• Most common: drowsiness, especially during the first or second week of therapy. If the drowsiness becomes troublesome, contact your doctor.
• Less common: jaundice (yellowing of the whites of the eyes or skin), which usually occurs in the first 2 to 4 weeks. The jaundice usually goes away when the drug is discontinued, but there have been cases where it did not. If you notice this effect or develop fever, or generally do not feel well, contact your doctor immediately. Other less common side effects are changes in components of the blood (including anemias), raised or lowered blood pressure, abnormal heartbeat, heart attack, and feeling faint or dizzy.
• Other: extra pyramidal effects, such as spasms of the neck muscles, severe stiffness of the back muscles, rolling back of the eyes, convulsions, difficulty in swallowing, and symptoms associated with Parkinson’s disease. These effects seem very serious but disappear after the drug has been withdrawn; however, symptoms of the face, tongue, or jaw may persist for years, especially in seniors with a long history of brain disease. If you experience any of these effects, contact your doctor immediately.

Haloperidol may cause an unusual increase in psychotic symptoms or may cause paranoid reactions, tiredness, lethargy, restlessness, hyperactivity, confusion at night, bizarre dreams, inability to sleep, depression, or euphoria (feeling “high”). Other reactions are itching, swelling, unusual sensitivity to bright light, red skin or rash, dry mouth, stuffy nose, headache, nausea, vomiting, loss of appetite, change in body temperature, loss of facial color, excessive salivation, excessive perspiration, constipation, diarrhea, changes in urine and bowel habits, worsening of glaucoma, blurred vision, weakening of eyelid muscles, and spasms of bronchial and other muscles, as well as increased appetite, fatigue, excessive thirst, and skin discoloration (particularly in sun-exposed areas). There have been cases of breast enlargement, false-positive pregnancy tests, changes in menstrual flow in females, and impotence and changes in sex drive in males.

Haloperidol Drug Interactions

• Be cautious about taking Haloperidol with barbiturates/ sleeping pills, narcotics or other tranquilizers, alcohol, or any other medication that may produce a depressive effect.
• Anticholinergic drugs can reduce the effectiveness of Haloperidol and increase the chance of drug side effects.
• The blood-pressure-lowering effect of Guanethidine may
be counteracted by Haloperidol.
• Taking Lithium together with Haloperidol may lead to disorientation or loss of consciousness. This combination may also cause uncontrolled muscle movements.
• Mixing Propranolol and Haloperidol may lead to unusually low blood pressure.
• Blood concentrations of tricyclic antidepressant drugs may increase if they are taken together with Haloperidol. This can lead to antidepressant side effects.

Food Interactions

This medicine is best taken on an empty stomach, but you may take it with food if it upsets your stomach.

Haloperidol Usual Dose

Adult: 0.5 to 2 mg 2 to 3 times per day to start. Your doctor may later increase your dose according to your need (up to 100 mg per day). Seniors generally need smaller doses.
Child (age 3 to 12 years, or 33 to 88 pounds): 0.5 mg per day to start. Dose may be increased in 0.5-mg steps every 5 to 7 days until a satisfactory effect is realized.
Child (under age 3): not recommended.

Overdosage

Symptoms of overdosage are depression, extreme weakness, tiredness, desire to sleep, coma, lowered blood pressure, uncontrolled muscle spasms, agitation, restlessness, convulsions, fever, dry mouth, and abnormal heart rhythms. The victim should be taken to a hospital emergency room immediately. ALWAYS bring the medicine bottle.

Haloperidol Special Information

This medication may cause drowsiness. Use caution when driving or operating hazardous equipment; also, avoid alcoholic beverages while taking the medicine.

The drug may cause unusual sensitivity to the sun. It can also turn your urine reddish-brown to pink.
If dizziness occurs, avoid sudden changes in posture and avoid climbing stairs. Use caution in hot weather. This medicine may make you more prone to heat stroke.

If you forget to take a dose of Haloperidol, take it as soon as you remember. Take the rest of the day’s doses evenly spaced throughout the day. Do not take a double dose.

Special Populations

Pregnancy/Breast-feeding
Serious problems have been seen in pregnant animals given large amounts of Haloperidol. Although Haloperidol has not been studied in pregnant women, you should avoid this drug if you are pregnant.
Haloperidol passes into breast milk. Nursing mothers who must use this medicine should bottle-feed their babies to avoid possible side effects in their infants.

Seniors
Older adults are more sensitive to the effects of this medication and usually require ½ to ¼ the usual adult dose to achieve the desired results. Also, seniors are more likely to develop drug side effects.