Haloperidol

Brand names

• Alti-Haloperidol
• Apo-Haloperidol
• Haldol
• Haldol LA
• Haloperidol
• Haloperidol-LA
• Halperon
• Novo-Peridol
• Peridol
• PMS-Haloperidol
• Rho-Haloperidol Decanoate

Usage

To treat moderate to severe psychiatric conditions including schizophrenia, manic states, and medicament-induced psychosis. Also used to treat extreme behavior problems in children (including infantile autism), to ease symptoms of Tourette's syndrome, and to reduce nausea and vomiting associated with chemotherapy for cancer.

How it works

Haloperidol blocks receptors of dopamine (a chemical that aids in the transmission of nerve impulses) in the central nervous system. Presumably, this produces a tranquilizing or antipsychotic effect.

Side effects

Serious

Rapid heartbeat, profuse sweating, seizures, difficulty breathing, neck stiffness, swelling of the tongue, difficulty swallowing. Also a rare condition can develop called neuroleptic malignant syndrome, characterized by stiffness or spasms of the muscles, high fever, and confusion or disorientation.

Common

Nausea, reduced sweating, dry mouth, blurred vision, drowsiness, shaking of hands, stiffness, stooped posture.

Less common

Difficult urination, menstrual irregularities, breast pain or swelling, unexpected weight gain, uncontrolled movements of the tongue, fever, chills, sore throat, unusual bruising or bleeding, heart palpitations, skin rash, itching, increased sensitivity of the skin to sunlight.

Possible interactions

Other medicaments:

Haloperidol may increase the effects of:

• all medicaments with sedative actions and cause excessive sedation.
• some antihypertensive medicaments and cause excessive lowering of blood pressure; monitor the combined effects carefully.
• fluvoxamine (Luvox) and result in toxicity (altered mental status, GI side effects).

Haloperidol may decrease the effects of:

• guanethidine (Esimil, Ismelin) and reduce its antihypertensive effect.

Haloperidol taken concurrently with:

• anticholinergic medicaments can cause additive anticholinergic effects (dry mouth, constipation or sedation).
• beta-blocker medicaments may cause excessive lowering of blood pressure.
• dextromethorphan (common cough suppressant in cough medicines) may lead to dextromethorphan toxicity.
• fluoxetine (Prozac) can result in an increased risk of haloperidol toxicity.
• fluvoxamine (Luvox) can result in an increased risk of haloperidol toxicity.
• lithium (Lithobid, others) may cause toxic effects on the brain and nervous system.
• MAO inhibitors may exaggerate low blood pressure and brain (CNS) effects.
• methyldopa (Aldomet) may cause serious dementia.
• olanzapine (Zyprexa) may lead to Parkinson-like symptoms.
• paroxetine (Paxil) may lead to haloperidol toxicity.
• quinidine (Quinaglute, others) may lead to haloperidol toxicity.
• ritonavir (Norvir) and perhaps other protease inhibitors may lead to toxicity.
• sertraline (Zoloft) may lead to haloperidol toxicity.
• sparfloxacin (Zagam) may lead to abnormal heartbeats.
• tacrine (Cognex) may lead to Parkinson-like symptoms.
• tramadol (Ultram) may lead to seizures.
• venlafaxine (Effexor) may lead to haloperidol toxicity.

The following medicaments may decrease the effects of haloperidol:

• antacids containing aluminum and/or magnesium, which may reduce its absorption.
• barbiturates.
• benztropine (Cogentin).
• buspirone (Buspar).
• carbamazepine (Tegretol).
• phenytoin (Dilantin) or fosphenytoin (Cerebyx).
• rifampin (Rifater, others).
• trihexyphenidyl (Artane).

Herbal medicines or minerals:

St. John's wort may also lead to increased sensitivity to the sun - do not combine. Since part of the way ginseng works may be as an MAO inhibitor, do not combine.

Alcohol:

Alcohol can increase the sedative action of haloperidol and accentuate its depressant effects on brain function. Haloperidol can increase the intoxicating effects of alcohol.

Tobacco smoking:

Combination with nicotine actually increased suppression of tics in Tourette's syndrome in one study.

Marijuana smoking:

Moderate increase in drowsiness; accentuation of orthostatic hypotension; increased risk of precipitating latent psychosis, confusing interpretation of mental status and of medicament response.

Exposure to sun:

Use caution-this medicament can cause photosensitivity.

Exposure to heat:

Use caution in hot environments. This medicament may impair the regulation of body temperature and increase the risk of heatstroke.

Exposure to cold:

This medicament can increase the risk of hypothermia in the elderly.

Discontinuation:

This medicament should not be stopped abruptly following long-term use. Gradual withdrawal over a period of 2 to 3 weeks is advised. Ask your doctor for help.

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