Haloperidol

Last updated

Haloperidol
Haloperidol.svg
Haloperidol-from-xtal-3D-balls.png
Clinical data
Pronunciation /ˌhæloʊˈpɛrɪdɒl/
Trade names Haldol, others
AHFS/Drugs.com Monograph
MedlinePlus a682180
License data
Pregnancy
category
Routes of
administration 		By mouth, intramuscular, intravenous, depot (as decanoate ester)
Drug class Typical antipsychotic
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability 60–70% (by mouth) [4]
Protein binding ~90% [4]
Metabolism Liver-mediated [4]
Metabolites • HPP+ [5] [6] [7]
Elimination half-life 14–26 hours (IV), 20.7 hours (IM), 14–37 hours (oral) [4]
Excretion Biliary (hence in feces) and in urine [4] [8]
Identifiers
  • 4-[4-(4-Chlorophenyl)-4-hydroxypiperidin-1-yl]-1-(4-fluorophenyl)butan-1-one
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard 100.000.142 OOjs UI icon edit-ltr-progressive.svg
Chemical and physical data
Formula C21H23ClFNO2
Molar mass 375.87 g·mol−1
3D model (JSmol)
  • c1cc(ccc1C(=O)CCCN2CCC(CC2)(c3ccc(cc3)Cl)O)F
  • InChI=1S/C21H23ClFNO2/c22-18-7-5-17(6-8-18)21(26)11-14-24(15-12-21)13-1-2-20(25)16-3-9-19(23)10-4-16/h3-10,26H,1-2,11-15H2 Yes check.svgY
  • Key:LNEPOXFFQSENCJ-UHFFFAOYSA-N Yes check.svgY
   (verify)

Haloperidol, sold under the brand name Haldol among others, is a typical antipsychotic medication. [9] Haloperidol is used in the treatment of schizophrenia, tics in Tourette syndrome, mania in bipolar disorder, delirium, agitation, acute psychosis, and hallucinations from alcohol withdrawal. [9] [10] [11] It may be used by mouth or injection into a muscle or a vein. [9] Haloperidol typically works within 30 to 60 minutes. [9] A long-acting formulation may be used as an injection every four weeks for people with schizophrenia or related illnesses, who either forget or refuse to take the medication by mouth. [9]

Contents

Haloperidol may result in a movement disorder known as tardive dyskinesia, which may be permanent. [9] Neuroleptic malignant syndrome and QT interval prolongation may occur, the latter particularly with IV administration. [9] In older people with psychosis due to dementia it results in an increased risk of death. [9] When taken during pregnancy it may result in problems in the infant. [9] [12] It should not be used by people with Parkinson's disease. [9]

Haloperidol was discovered in 1958 by the team of Paul Janssen, [13] prepared as part of a structure-activity relationship investigation into analogs of pethidine (meperidine). [14] It is on the World Health Organization's List of Essential Medicines. [15] It is the most commonly used typical antipsychotic. [16] In 2020, it was the 303rd most commonly prescribed medication in the United States, with more than 1 million prescriptions. [17]

Medical uses

Haloperidol is used in the control of the symptoms of:

Haloperidol was considered indispensable for treating psychiatric emergency situations. [24] [25] However, the newer atypical drugs have gained a greater role in a number of situations, as outlined in a series of consensus reviews published between 2001 and 2005. [26] [27] [28]

In a 2013 comparison of 15 antipsychotics in schizophrenia, haloperidol demonstrated standard effectiveness. It was 13–16% more effective than ziprasidone, chlorpromazine, and asenapine, approximately as effective as quetiapine and aripiprazole, and 10% less effective than paliperidone. [29] A 2013 systematic review compared haloperidol to placebo in schizophrenia: [30]

Summary
Haloperidol often causes troublesome adverse effects. If there is no other antipsychotic drug, using haloperidol to offset the consequences of untreated schizophrenia is justified. Where a choice of drug is available, however, an alternative antipsychotic with less likelihood of adverse effects such as parkinsonism, akathisia and acute dystonias may be more desirable. [30]

In contrast to certain other antipsychotics like risperidone, haloperidol is ineffective as a hallucinogen antidote or "trip killer" in blocking the effects of serotonergic psychedelics like psilocybin and lysergic acid diethylamide (LSD). [31] [32] [33]

Pregnancy and lactation

Data from animal experiments indicate haloperidol is not teratogenic, but is embryotoxic in high doses. In humans, no controlled studies exist. Reports in pregnant women revealed possible damage to the fetus, although most of the women were exposed to multiple drugs during pregnancy. In addition, reports indicate neonates exposed to antipsychotic drugs are at risk for extrapyramidal and/or withdrawal symptoms following delivery, such as agitation, hypertonia, hypotonia, tremor, somnolence, respiratory distress, and feeding disorder. Following accepted general principles, haloperidol should be given during pregnancy only if the benefit to the mother clearly outweighs the potential fetal risk. [21]

Haloperidol is excreted in breast milk. A few studies have examined the impact of haloperidol exposure on breastfed infants and in most cases, there were no adverse effects on infant growth and development. [34]

Other considerations

Skeletal formula of haloperidol decanoate. The decanoate group is highlighted in @media screen{html.skin-theme-clientpref-night .mw-parser-output div:not(.notheme)>.tmp-color,html.skin-theme-clientpref-night .mw-parser-output p>.tmp-color,html.skin-theme-clientpref-night .mw-parser-output table:not(.notheme) .tmp-color{color:inherit!important}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output div:not(.notheme)>.tmp-color,html.skin-theme-clientpref-os .mw-parser-output p>.tmp-color,html.skin-theme-clientpref-os .mw-parser-output table:not(.notheme) .tmp-color{color:inherit!important}} red. Haloperidol decanoate highlighting ester group.svg
Skeletal formula of haloperidol decanoate. The decanoate group is highlighted in red.

During long-term treatment of chronic psychiatric disorders, the daily dose should be reduced to the lowest level needed for maintenance of remission. Sometimes, it may be indicated to terminate haloperidol treatment gradually.[ citation needed ] In addition, during long-term use, routine monitoring including measurement of BMI, blood pressure, fasting blood sugar, and lipids, is recommended due to the risk of side effects. [35]

Other forms of therapy (psychotherapy, occupational therapy/ergotherapy, or social rehabilitation) should be instituted properly.[ citation needed ] PET imaging studies have suggested low doses are preferable. Clinical response was associated with at least 65% occupancy of D2 receptors, while greater than 72% was likely to cause hyperprolactinaemia and over 78% associated with extrapyramidal side effects. Doses of haloperidol greater than 5 mg increased the risk of side effects without improving efficacy. [36] Patients responded with doses under even 2 mg in first-episode psychosis. [37] For maintenance treatment of schizophrenia, an international consensus conference recommended a reduction dosage by about 20% every 6 months until a minimal maintenance dose is established. [35]

The decanoate ester of haloperidol (haloperidol decanoate, trade names Haldol decanoate, Halomonth, Neoperidole) has a much longer duration of action, so is often used in people known to be noncompliant with oral medication. A dose is given by intramuscular injection once every two to four weeks. [38] The IUPAC name of haloperidol decanoate is [4-(4-chlorophenyl)-1-[4-(4-fluorophenyl)-4-oxobutyl]piperidin-4-yl] decanoate.

Topical formulations of haloperidol should not be used as treatment for nausea because research does not indicate this therapy is more effective than alternatives. [39]

Adverse effects

Sources for the following lists of adverse effects: [40] [41] [42] [43]

As haloperidol is a high-potency typical antipsychotic, it tends to produce significant extrapyramidal side effects. According to a 2013 meta-analysis of the comparative efficacy and tolerability of 15 antipsychotic drugs it was the most prone of the 15 for causing extrapyramidal side effects. [29]

With more than 6 months of use 14 percent of users gain weight. [44] Haloperidol may be neurotoxic. [45]

Haloperidol, like all butyrophenone derivatives, destroy neurons (gray matter of the brain) - claims psychiatrist and addiction physician Alexander Danilin [46]

Prolonged use of the drug can lead to mental dependence. [47]

Common (>1% incidence)

Unknown frequency

Rare (<1% incidence)

Contraindications

Special cautions

Interactions

Potential neurotoxicity

Several lines of evidence suggest that haloperidol exhibits neurotoxicity. [53] [54] Some studies report an association between antipsychotic medications, especially first-generation agents, and a decline in gray matter volume. [55] Haloperidol irreversibly blocks the sigma σ1 receptor. [56] It may exert deleterious effects on the dorsolateral prefrontal cortex (DLPFC) by attenuating brain-derived neurotrophic factor (BDNF) transcription and expression, associated with an increase in the long non-coding RNA BDNF-AS in the DLPFC. [57] Besides the preceding mechanisms, haloperidol metabolizes into HPP+, a monoaminergic neurotoxin related to MPTP. [5] [6] [7] This might be involved in the extrapyramidal symptoms that develop with long-term haloperidol therapy. [5] [6] [7]

Discontinuation

The British National Formulary recommends a gradual withdrawal when discontinuing antipsychotics to avoid acute withdrawal syndrome or rapid relapse. [58] Symptoms of withdrawal commonly include nausea, vomiting, and loss of appetite. [59] Other symptoms may include restlessness, increased sweating, and trouble sleeping. [59] Less commonly there may be a feeling of the world spinning, numbness, or muscle pains. [59] Symptoms generally resolve after a short period of time. [59]

There is tentative evidence that discontinuation of antipsychotics can result in psychosis. [60] It may also result in reoccurrence of the condition that is being treated. [61] Rarely tardive dyskinesia can occur when the medication is stopped. [59]

Overdose

Symptoms

Symptoms are usually due to side effects. Most often encountered are:

Treatment

Treatment is mostly symptomatic and involves intensive care with stabilization of vital functions. In early detected cases of oral overdose, induction of emesis, gastric lavage, and the use of activated charcoal can be tried. In the case of a severe overdose, antidotes such as bromocriptine or ropinirole may be used to treat the extrapyramidal effects caused by haloperidol, acting as dopamine receptor agonists.[ citation needed ] ECG and vital signs should be monitored especially for QT prolongation and severe arrhythmias should be treated with antiarrhythmic measures. [21]

Prognosis

An overdose of haloperidol can be fatal, [62] but in general the prognosis after overdose is good, provided the person has survived the initial phase.

Pharmacology

Haloperidol, 10-mg oral tablet Haloperidol 10 MG Oral Tablet.jpg
Haloperidol, 10-mg oral tablet

Haloperidol is a typical butyrophenone-type antipsychotic that exhibits high-affinity dopamine D2 receptor antagonism and slow receptor dissociation kinetics. [63] It has effects similar to the phenothiazines. [23] The drug binds preferentially to D2 and α1 receptors at low dose (ED50 = 0.13 and 0.42 mg/kg, respectively), and 5-HT2 receptors at a higher dose (ED50 = 2.6 mg/kg). Given that antagonism of D2 receptors is more beneficial on the positive symptoms of schizophrenia and antagonism of 5-HT2 receptors on the negative symptoms, this characteristic underlies haloperidol's greater effect on delusions, hallucinations and other manifestations of psychosis. [64] Haloperidol's negligible affinity for histamine H1 receptors and muscarinic M1 acetylcholine receptors yields an antipsychotic with a lower incidence of sedation, weight gain, and orthostatic hypotension though having higher rates of treatment emergent extrapyramidal symptoms.

Haloperidol binding profile
ReceptorAction Ki (nM)
D1 silent antagonist Unknown efficiency [ citation needed ]
D5 silent antagonistUnknown efficiency[ citation needed ]
D2 inverse agonist 0.7 [65]
D3 inverse agonist0.2 [66]
D4 inverse agonist5–9 [67]
σ1 (irreversible inactivation by haloperidol metabolites)3 [68]
σ2 agonist54 [69]
5-HT1A agonist1927 [70]
5-HT2A silent antagonist53 [70]
5-HT2C silent antagonist10000+ [70]
5-HT6 silent antagonist3666 [70]
5-HT7 irreversible silent antagonist 377.2 [70]
H1 silent antagonist1800 [70]
M1 silent antagonist10000+ [70]
α1A silent antagonist12 [70]
α2A Agonist1130 [70]
α2B Agonist480 [70]
α2C Agonist550 [70]
NR1/NR2B subunit containing NMDA receptor antagonist; ifenprodil site IC50 – 2,000 [71]

Pharmacokinetics

By mouth

The bioavailability of oral haloperidol ranges from 60 to 70%. However, there is a wide variance in reported mean Tmax and T1/2 in different studies, ranging from 1.7 to 6.1 hours and 14.5 to 36.7 hours respectively. [4]

Intramuscular injections

Haldol Decanoate for injection into muscle Haldol Decanoate.jpg
Haldol Decanoate for injection into muscle

The drug is well and rapidly absorbed with a high bioavailability when injected intramuscularly. The Tmax is 20 minutes in healthy individuals and 33.8 minutes in patients with schizophrenia. The mean T1/2 is 20.7 hours. [4] The decanoate injectable formulation is for intramuscular administration only and is not intended to be used intravenously. The plasma concentrations of haloperidol decanoate reach a peak at about six days after the injection, falling thereafter, with an approximate half-life of three weeks. [73]

Intravenous injections

The bioavailability is 100% in intravenous (IV) injection, and the very rapid onset of action is seen within seconds. The T1/2 is 14.1 to 26.2 hours. The apparent volume of distribution is between 9.5 and 21.7 L/kg. [4] The duration of action is four to six hours.

Therapeutic concentrations

Plasma levels of five to 15 micrograms per liter are typically seen for therapeutic response (Ulrich S, et al. Clin Pharmacokinet. 1998). The determination of plasma levels is rarely used to calculate dose adjustments but can be useful to check compliance.

The concentration of haloperidol in brain tissue is about 20-fold higher compared to blood levels. It is slowly eliminated from brain tissue, [74] which may explain the slow disappearance of side effects when the medication is stopped. [74] [75]

Distribution and metabolism

Haloperidol is heavily protein bound in human plasma, with a free fraction of only 7.5 to 11.6%. It is also extensively metabolized in the liver with only about 1% of the administered dose excreted unchanged in the urine. The greatest proportion of the hepatic clearance is by glucuronidation, followed by reduction and CYP-mediated oxidation, primarily by CYP3A4. [4] Haloperidol is metabolized into HPP+, a monoaminergic neurotoxin related to MPTP, by CYP3A enzymes. [5] [6] [7]

Chemistry

Haloperidol is a crystalline material with a melting temperature of 150 °C. [76] This drug has very low solubility in water (1.4 mg/100 mL), but it is soluble in chloroform, benzene, methanol, and acetone. It is also soluble in 0.1 M hydrochloric acid (3 mg/mL) with heating. [77]

History

Haloperidol was discovered by Paul Janssen. [78] It was developed in 1958 at the Belgian company Janssen Pharmaceutica and submitted to the first of clinical trials in Belgium later that year. [79] [80]

Haloperidol was approved by the U.S. Food and Drug Administration (FDA) on 12 April 1967; it was later marketed in the U.S. and other countries under the brand name Haldol by McNeil Laboratories. [79]

Society and culture

Cost

Haloperidol is relatively inexpensive, being up to 100 fold less expensive than newer antipsychotics. [81] [82]

Names

Haloperidol is the INN, BAN, USAN, AAN approved name.

It is sold under the tradenames Aloperidin, Bioperidolo, Brotopon, Dozic, Duraperidol (Germany), Einalon S, Eukystol, Haldol (common tradename in the US and UK), Halol, Halosten, Keselan, Linton, Peluces, Serenace Norodol (Turkey) and Sigaperidol.[ citation needed ]

Research

Haloperidol was under investigation for the treatment of depression. [83] [84] It was employed as a short-term low-dose dopamine receptor antagonist to upregulate dopamine receptors and produce receptor supersensitivity followed by drug withdrawal as a means of treating depression. [83] [85] [84]

Veterinary use

Haloperidol is also used on many different kinds of animals for nonselective tranquilization and diminishing behavioral arousal, in veterinary and other settings including captivity management. [86]

Related Research Articles

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Antipsychotics, previously known as neuroleptics and major tranquilizers, are a class of psychotropic medication primarily used to manage psychosis, principally in schizophrenia but also in a range of other psychotic disorders. They are also the mainstay, together with mood stabilizers, in the treatment of bipolar disorder. Moreover, they are also used as adjuncts in the treatment of treatment-resistant major depressive disorder.

<span class="mw-page-title-main">Chlorpromazine</span> Typical antipsychotic medication

Chlorpromazine (CPZ), marketed under the brand names Thorazine and Largactil among others, is an antipsychotic medication. It is primarily used to treat psychotic disorders such as schizophrenia. Other uses include the treatment of bipolar disorder, severe behavioral problems in children including those with attention deficit hyperactivity disorder, nausea and vomiting, anxiety before surgery, and hiccups that do not improve following other measures. It can be given orally, by intramuscular injection, or intravenously.

<span class="mw-page-title-main">Fluphenazine</span> Typical antipsychotic medication

Fluphenazine, sold under the brand name Prolixin among others, is a high-potency typical antipsychotic medication. It is used in the treatment of chronic psychoses such as schizophrenia, and appears to be about equal in effectiveness to low-potency antipsychotics like chlorpromazine. It is given by mouth, injection into a muscle, or just under the skin. There is also a long acting injectable version that may last for up to four weeks. Fluphenazine decanoate, the depot injection form of fluphenazine, should not be used by people with severe depression.

<span class="mw-page-title-main">Typical antipsychotic</span> Class of drugs

Typical antipsychotics are a class of antipsychotic drugs first developed in the 1950s and used to treat psychosis. Typical antipsychotics may also be used for the treatment of acute mania, agitation, and other conditions. The first typical antipsychotics to come into medical use were the phenothiazines, namely chlorpromazine which was discovered serendipitously. Another prominent grouping of antipsychotics are the butyrophenones, an example of which is haloperidol. The newer, second-generation antipsychotics, also known as atypical antipsychotics, have largely supplanted the use of typical antipsychotics as first-line agents due to the higher risk of movement disorders with typical antipsychotics.

<span class="mw-page-title-main">Atypical antipsychotic</span> Class of pharmaceutical drugs

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<span class="mw-page-title-main">Risperidone</span> Antipsychotic medication

Risperidone, sold under the brand name Risperdal among others, is an atypical antipsychotic used to treat schizophrenia and bipolar disorder, as well as aggressive and self-injurious behaviors associated with autism spectrum disorder. It is taken either by mouth or by injection. The injectable versions are long-acting and last for 2–4 weeks.

<span class="mw-page-title-main">Perphenazine</span> Antipsychotic medication

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<span class="mw-page-title-main">Dopamine antagonist</span> Drug which blocks dopamine receptors

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<span class="mw-page-title-main">Clocapramine</span> Antipsychotic medication

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<span class="mw-page-title-main">Aripiprazole lauroxil</span> Chemical compound

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References

  1. ↑ "Haloperidol Use During Pregnancy". Drugs.com. 10 February 2020. Retrieved 13 September 2020.
  2. ↑ Anvisa (31 March 2023). "RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial" [Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control] (in Brazilian Portuguese). Diário Oficial da União (published 4 April 2023). Archived from the original on 3 August 2023. Retrieved 16 August 2023.
  3. ↑ "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA . Retrieved 22 October 2023.
  4. 1 2 3 4 5 6 7 8 9 Kudo S, Ishizaki T (December 1999). "Pharmacokinetics of haloperidol: an update". Clinical Pharmacokinetics. 37 (6): 435–456. doi:10.2165/00003088-199937060-00001. PMID   10628896. S2CID   71360020.
  5. 1 2 3 4 Kostrzewa RM (2022). "Survey of Selective Monoaminergic Neurotoxins Targeting Dopaminergic, Noradrenergic, and Serotoninergic Neurons". Handbook of Neurotoxicity. Cham: Springer International Publishing. pp. 159–198. doi:10.1007/978-3-031-15080-7_53. ISBN   978-3-031-15079-1.
  6. 1 2 3 4 Igarashi K (1998). "The Possible Role of an Active Metafbollte Derived from the Neuroleptic Agent Haloperidol in Drug-Induced Parkinsonism". Journal of Toxicology: Toxin Reviews. 17 (1): 27–38. doi:10.3109/15569549809006488. ISSN   0731-3837.
  7. 1 2 3 4 Górska A, Marszałł M, Sloderbach A (October 2015). "Neurotoksyczność pirydyniowych metabolitów haloperydolu" [The neurotoxicity of pyridinium metabolites of haloperidol]. Postepy Hig Med Dosw (Online) (in Polish). 69: 1169–1175. doi: 10.5604/17322693.1175009 (inactive 1 November 2024). PMID   26561842.{{cite journal}}: CS1 maint: DOI inactive as of November 2024 (link)
  8. ↑ "Product Information Serenace" (PDF). TGA eBusiness Services. Aspen Pharma Pty Ltd. 29 September 2011. Archived from the original on 14 March 2017. Retrieved 29 May 2014.
  9. 1 2 3 4 5 6 7 8 9 10 "Haloperidol". The American Society of Health-System Pharmacists. Archived from the original on 2 January 2015. Retrieved 2 January 2015.
  10. 1 2 Schuckit MA (November 2014). "Recognition and management of withdrawal delirium (delirium tremens)". The New England Journal of Medicine. 371 (22): 2109–2113. doi:10.1056/NEJMra1407298. PMID   25427113. S2CID   205116954.
  11. ↑ Plosker GL (July 2012). "Quetiapine: a pharmacoeconomic review of its use in bipolar disorder". PharmacoEconomics. 30 (7): 611–631. doi:10.2165/11208500-000000000-00000. PMID   22559293.
  12. ↑ "Prescribing medicines in pregnancy database". Australian Government. 3 March 2014. Archived from the original on 8 April 2014. Retrieved 2 January 2015.
  13. ↑ Sneader W (2005). Drug discovery : a history (Rev. and updated ed.). Chichester: Wiley. p. 124. ISBN   978-0-471-89979-2. Archived from the original on 8 December 2015.
  14. ↑ Ravina E (2011). The evolution of drug discovery: from traditional medicines to modern drugs (1. Aufl. ed.). Weinheim: Wiley-VCH. p. 62. ISBN   978-3-527-32669-3. Archived from the original on 8 December 2015.
  15. ↑ World Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. hdl: 10665/345533 . WHO/MHP/HPS/EML/2021.02.
  16. ↑ Stevens A (2004). Health care needs assessment: the epidemiologically based needs assessment reviews (2nd ed.). Abingdon: Radcliffe Medical. p. 202. ISBN   978-1-85775-892-4. Archived from the original on 8 December 2015.
  17. ↑ "Haloperidol - Drug Usage Statistics". ClinCalc. Retrieved 7 October 2022.
  18. ↑ Giannini AJ, Underwood NA, Condon M (November 2000). "Acute ketamine intoxication treated by haloperidol: a preliminary study". American Journal of Therapeutics. 7 (6): 389–391. doi:10.1097/00045391-200007060-00008. PMID   11304647.
  19. ↑ Giannini AJ, Eighan MS, Loiselle RH, Giannini MC (April 1984). "Comparison of haloperidol and chlorpromazine in the treatment of phencyclidine psychosis". Journal of Clinical Pharmacology. 24 (4): 202–204. doi:10.1002/j.1552-4604.1984.tb01831.x. PMID   6725621. S2CID   42278510.
  20. ↑ Johnson M, Richards W, Griffiths R (August 2008). "Human hallucinogen research: guidelines for safety". Journal of Psychopharmacology. 22 (6). SAGE Publications: 603–620. doi:10.1177/0269881108093587. PMC   3056407 . PMID   18593734.
  21. 1 2 3 4 5 6 "Haldol Official FDA information, side effects and uses". Drugs.com. Archived from the original on 5 October 2013. Retrieved 3 October 2013.
  22. ↑ Joint Formulary Committee (2013). British National Formulary (BNF) (65th ed.). London, England: Pharmaceutical Press. pp.  229–30. ISBN   978-0-85711-084-8.
  23. 1 2 Brayfield, A, ed. (13 December 2013). "Haloperidol". Martindale: The Complete Drug Reference. London, UK: Pharmaceutical Press. Retrieved 29 May 2014.
  24. 1 2 Currier GW (January 2003). "The controversy over "chemical restraint" in acute care psychiatry". Journal of Psychiatric Practice. 9 (1). Lippincott Williams & Wilkins: 59–70. doi:10.1097/00131746-200301000-00006. PMID   15985915. S2CID   22342074.
  25. ↑ Cavanaugh SV (September 1986). "Psychiatric emergencies". The Medical Clinics of North America. 70 (5): 1185–1202. doi:10.1016/S0025-7125(16)30919-1. PMID   3736271.
  26. ↑ Allen MH, Currier GW, Hughes DH, Reyes-Harde M, Docherty JP (May 2001). "The Expert Consensus Guideline Series. Treatment of behavioral emergencies". Postgraduate Medicine (Spec No): 1–88, quiz 89–90. PMID   11500996.
  27. ↑ Allen MH, Currier GW, Hughes DH, Docherty JP, Carpenter D, Ross R (January 2003). "Treatment of behavioral emergencies: a summary of the expert consensus guidelines". Journal of Psychiatric Practice. 9 (1): 16–38. doi:10.1097/00131746-200301000-00004. PMID   15985913. S2CID   29363701.
  28. ↑ Allen MH, Currier GW, Carpenter D, Ross RW, Docherty JP (November 2005). "The expert consensus guideline series. Treatment of behavioral emergencies 2005". Journal of Psychiatric Practice. 11 (Suppl 1): 5–25. doi:10.1097/00131746-200511001-00002. PMID   16319571. S2CID   72366588.
  29. 1 2 3 Leucht S, Cipriani A, Spineli L, Mavridis D, Orey D, Richter F, et al. (September 2013). "Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis". Lancet. 382 (9896): 951–962. doi:10.1016/S0140-6736(13)60733-3. PMID   23810019. S2CID   32085212.
  30. 1 2 Adams CE, Bergman H, Irving CB, Lawrie S (November 2013). "Haloperidol versus placebo for schizophrenia". The Cochrane Database of Systematic Reviews. 2013 (11): CD003082. doi: 10.1002/14651858.CD003082.pub3 . PMC   11558230 . PMID   24242360. Archived from the original on 20 August 2017.
  31. ↑ Halman A, Kong G, Sarris J, Perkins D (January 2024). "Drug-drug interactions involving classic psychedelics: A systematic review". J Psychopharmacol. 38 (1): 3–18. doi:10.1177/02698811231211219. PMC   10851641 . PMID   37982394.
  32. ↑ Halberstadt AL (January 2015). "Recent advances in the neuropsychopharmacology of serotonergic hallucinogens". Behav Brain Res. 277: 99–120. doi:10.1016/j.bbr.2014.07.016. PMC   4642895 . PMID   25036425.
  33. ↑ Vollenweider FX, Vollenweider-Scherpenhuyzen MF, Bäbler A, Vogel H, Hell D (December 1998). "Psilocybin induces schizophrenia-like psychosis in humans via a serotonin-2 agonist action". NeuroReport. 9 (17): 3897–3902. doi:10.1097/00001756-199812010-00024. PMID   9875725.
  34. ↑ "LACTMED: Haloperidol". 31 October 2018. Retrieved 18 January 2019.
  35. 1 2 Work Group on Schizophrenia. "Practice Guideline for the Treatment of Patients With Schizophrenia" (Second ed.). Archived from the original on 27 March 2012. Retrieved 21 April 2014.
  36. ↑ Oosthuizen P, Emsley RA, Turner J, Keyter N (December 2001). "Determining the optimal dose of haloperidol in first-episode psychosis". Journal of Psychopharmacology. 15 (4): 251–255. doi:10.1177/026988110101500403. PMID   11769818. S2CID   40788955.
  37. ↑ Tauscher J, Kapur S (2001). "Choosing the right dose of antipsychotics in schizophrenia: lessons from neuroimaging studies". CNS Drugs. 15 (9): 671–678. doi:10.2165/00023210-200115090-00001. PMID   11580306. S2CID   30091494.
  38. ↑ Goodman and Gilman's Pharmacological Basis of Therapeutics, 10th edition (McGraw-Hill, 2001).[ page needed ]
  39. ↑ American Academy of Hospice and Palliative Medicine. "Five Things Physicians and Patients Should Question". Choosing Wisely: An Initiative of the ABIM Foundation. American Academy of Hospice and Palliative Medicine. Archived from the original on 1 September 2013. Retrieved 1 August 2013., which cites
  40. ↑ Product Information [Internet]. 2011 [cited 2013 Sep 29]. Available from: "TGA eBS - Product and Consumer Medicine Information Licence". Archived from the original on 14 March 2017. Retrieved 29 May 2014.
  41. ↑ HALDOL® Injection For Intramuscular Injection Only Product Information [Internet]. Janssen; 2011 [cited 2013 Sep 29]. Available from: "TGA eBS - Product and Consumer Medicine Information Licence". Archived from the original on 14 March 2017. Retrieved 29 September 2013.
  42. ↑ Truven Health Analytics, Inc. DrugPoint® System (Internet) [cited 2013 Sep 29]. Greenwood Village, CO: Thomsen Healthcare; 2013.
  43. ↑ Joint Formulary Committee. British National Formulary (BNF) 65. Pharmaceutical Pr; 2013.
  44. ↑ FDA Psychopharmacological Drugs Advisory Committee (9 July 2000). "Briefing Document for ZELDOX CAPSULES (Ziprasidone HCl)" (PDF). Food and Drug Administration . Archived from the original (PDF) on 19 January 2017. Retrieved 30 September 2016.
  45. ↑ Nasrallah HA, Chen AT (August 2017). "Multiple neurotoxic effects of haloperidol resulting in neuronal death". Annals of Clinical Psychiatry. 29 (3): 195–202. PMID   28738100.
  46. ↑ "Danilin A.G. / All videos". rideo.tv.
  47. ↑ "Haloperidol Withdrawal Symptoms: An Overview".
  48. ↑ Ballard C, Lana MM, Theodoulou M, Douglas S, McShane R, Jacoby R, et al. (April 2008). Brayne C (ed.). "A randomised, blinded, placebo-controlled trial in dementia patients continuing or stopping neuroleptics (the DART-AD trial)". PLOS Medicine. 5 (4): e76. doi: 10.1371/journal.pmed.0050076 . PMC   2276521 . PMID   18384230. Neuroleptics provided no benefit for patients with mild behavioural problems, but were associated with a marked deterioration in verbal skills
  49. ↑ "Medication 'worsens Alzheimer's'". BBC NEWS. 1 April 2008. Retrieved 3 August 2016.
  50. ↑ Leentjens AF, van der Mast RC (May 2005). "Delirium in elderly people: an update". Current Opinion in Psychiatry. 18 (3): 325–330. doi:10.1097/01.yco.0000165603.36671.97. PMID   16639157. S2CID   24709695.
  51. ↑ Bush SE, Hatton RC, Winterstein AG, Thomson MR, Woo GW (December 2008). "Effects of concomitant amiodarone and haloperidol on Q-Tc interval prolongation". American Journal of Health-System Pharmacy. 65 (23): 2232–2236. doi:10.2146/ajhp080039. PMID   19020191.
  52. ↑ Sandyk R, Hurwitz MD (November 1983). "Toxic irreversible encephalopathy induced by lithium carbonate and haloperidol. A report of 2 cases". South African Medical Journal = Suid-Afrikaanse Tydskrif vir Geneeskunde. 64 (22): 875–876. PMID   6415823.
  53. ↑ Nasrallah HA, Chen AT (August 2017). "Multiple neurotoxic effects of haloperidol resulting in neuronal death". Annals of Clinical Psychiatry. 29 (3): 195–202. PMID   28738100.
  54. ↑ Pierre JM. "Time to retire haloperidol?". Current Psychiatry. 19 (5): 19.
  55. ↑ Id.
  56. ↑ Cobos EJ, del Pozo E, Baeyens JM (August 2007). "Irreversible blockade of sigma-1 receptors by haloperidol and its metabolites in guinea pig brain and SH-SY5Y human neuroblastoma cells". Journal of Neurochemistry. 102 (3): 812–825. doi:10.1111/j.1471-4159.2007.04533.x. PMID   17419803.
  57. ↑ Hemby SE, McIntosh S (2023). "Chronic haloperidol administration downregulates select BDNF transcript and protein levels in the dorsolateral prefrontal cortex of rhesus monkeys". Frontiers in Psychiatry. 14: 1054506. doi: 10.3389/fpsyt.2023.1054506 . PMC   9932326 . PMID   36816400.
  58. ↑ Joint Formulary Committee B, ed. (March 2009). "4.2.1". British National Formulary (57 ed.). United Kingdom: Royal Pharmaceutical Society of Great Britain. p. 192. ISBN   978-0-85369-845-6. Withdrawal of antipsychotic drugs after long-term therapy should always be gradual and closely monitored to avoid the risk of acute withdrawal syndromes or rapid relapse.
  59. 1 2 3 4 5 Haddad PM, Dursun S, Deakin B (2004). Adverse Syndromes and Psychiatric Drugs: A Clinical Guide. OUP Oxford. pp. 207–216. ISBN   9780198527480.
  60. ↑ Moncrieff J (July 2006). "Does antipsychotic withdrawal provoke psychosis? Review of the literature on rapid onset psychosis (supersensitivity psychosis) and withdrawal-related relapse". Acta Psychiatrica Scandinavica. 114 (1): 3–13. doi:10.1111/j.1600-0447.2006.00787.x. PMID   16774655. S2CID   6267180.
  61. ↑ Sacchetti E, Vita A, Siracusano A, Fleischhacker W (2013). Adherence to Antipsychotics in Schizophrenia. Springer Science & Business Media. p. 85. ISBN   9788847026797.
  62. ↑ "Haloperidol at Drugs.com". Archived from the original on 22 November 2011.
  63. ↑ Seeman P, Tallerico T (March 1998). "Antipsychotic drugs which elicit little or no parkinsonism bind more loosely than dopamine to brain D2 receptors, yet occupy high levels of these receptors". Molecular Psychiatry. 3 (2): 123–134. doi: 10.1038/sj.mp.4000336 . PMID   9577836.
  64. ↑ Schotte A, Janssen PF, Megens AA, Leysen JE (December 1993). "Occupancy of central neurotransmitter receptors by risperidone, clozapine and haloperidol, measured ex vivo by quantitative autoradiography". Brain Research. 631 (2): 191–202. doi:10.1016/0006-8993(93)91535-z. PMID   7510574. S2CID   34455982.
  65. ↑ Leysen JE, Janssen PM, Gommeren W, Wynants J, Pauwels PJ, Janssen PA (March 1992). "In vitro and in vivo receptor binding and effects on monoamine turnover in rat brain regions of the novel antipsychotics risperidone and ocaperidone". Molecular Pharmacology. 41 (3): 494–508. PMID   1372084.
  66. ↑ Mohell N (April 1998). "Agonist and inverse agonist activity at the dopamine D3 receptor measured by guanosine 5'--gamma-thio-triphosphate--35S- binding". The Journal of Pharmacology and Experimental Therapeutics. 285 (1): 119–126. PMID   9536001.
  67. ↑ Leysen JE, Janssen PM, Megens AA, Schotte A (May 1994). "Risperidone: a novel antipsychotic with balanced serotonin-dopamine antagonism, receptor occupancy profile, and pharmacologic activity". The Journal of Clinical Psychiatry. 55 (Suppl): 5–12. PMID   7520908.
  68. ↑ Cobos EJ, del Pozo E, Baeyens JM (August 2007). "Irreversible blockade of sigma-1 receptors by haloperidol and its metabolites in guinea pig brain and SH-SY5Y human neuroblastoma cells". Journal of Neurochemistry. 102 (3): 812–825. doi:10.1111/j.1471-4159.2007.04533.x. PMID   17419803. S2CID   24130758.
  69. ↑ Colabufo NA, Berardi F, Contino M, Niso M, Abate C, Perrone R, et al. (August 2004). "Antiproliferative and cytotoxic effects of some sigma2 agonists and sigma1 antagonists in tumour cell lines". Naunyn-Schmiedeberg's Archives of Pharmacology. 370 (2): 106–113. doi:10.1007/s00210-004-0961-2. PMID   15322732. S2CID   24971006.
  70. 1 2 3 4 5 6 7 8 9 10 11 Kroeze WK, Hufeisen SJ, Popadak BA, Renock SM, Steinberg S, Ernsberger P, et al. (March 2003). "H1-histamine receptor affinity predicts short-term weight gain for typical and atypical antipsychotic drugs". Neuropsychopharmacology. 28 (3): 519–526. doi: 10.1038/sj.npp.1300027 . PMID   12629531.
  71. ↑ Ilyin VI, Whittemore ER, Guastella J, Weber E, Woodward RM (December 1996). "Subtype-selective inhibition of N-methyl-D-aspartate receptors by haloperidol". Molecular Pharmacology. 50 (6): 1541–1550. PMID   8967976.
  72. ↑ "Haldol Decanoate - Summary of Product Characteristics (SmPC) - (emc)". www.medicines.org.uk. Retrieved 26 December 2021.
  73. ↑ "drugs.com". Archived from the original on 10 August 2011.
  74. 1 2 Kornhuber J, Schultz A, Wiltfang J, Meineke I, Gleiter CH, Zöchling R, et al. (June 1999). "Persistence of haloperidol in human brain tissue". The American Journal of Psychiatry. 156 (6): 885–890. doi:10.1176/ajp.156.6.885. PMID   10360127.
  75. ↑ Kornhuber J, Wiltfang J, Riederer P, Bleich S (August 2006). "Neuroleptic drugs in the human brain: clinical impact of persistence and region-specific distribution". European Archives of Psychiatry and Clinical Neuroscience. 256 (5): 274–280. doi:10.1007/s00406-006-0661-7. PMID   16788768. S2CID   9565741.
  76. ↑ Shan X, Williams AC, Khutoryanskiy VV (November 2020). "Polymer structure and property effects on solid dispersions with haloperidol: Poly(N-vinyl pyrrolidone) and poly(2-oxazolines) studies" (PDF). International Journal of Pharmaceutics. 590: 119884. doi:10.1016/j.ijpharm.2020.119884. PMID   32950665. S2CID   221826541.
  77. ↑ "Sigma data sheet on haloperidol" (PDF).
  78. ↑ Healy D (1996). The psychopharmacologists. Vol. 1. London: Chapman and Hall. ISBN   978-1-86036-008-4.[ page needed ]
  79. 1 2 Granger B, Albu S (2005). "The haloperidol story". Annals of Clinical Psychiatry. 17 (3): 137–140. doi:10.1080/10401230591002048. PMID   16433054.
  80. ↑ López-Muñoz F, Alamo C (April 2009). "The consolidation of neuroleptic therapy: Janssen, the discovery of haloperidol and its introduction into clinical practice". Brain Research Bulletin. 79 (2): 130–141. doi:10.1016/j.brainresbull.2009.01.005. PMID   19186209. S2CID   7720401.
  81. ↑ Escobar JI, Marin H (2013). Clinical Psychopharmacology: A Practical Approach. World Scientific. p. 69. ISBN   978-981-4578-37-0.
  82. ↑ Adams JG (2012). Emergency Medicine E-Book: Clinical Essentials (Expert Consult -- Online). Elsevier Health Sciences. p. 1635. ISBN   978-1-4557-3394-1.
  83. 1 2 "CLR 3001". AdisInsight. 27 August 2019. Retrieved 13 August 2024.
  84. 1 2 Kennedy SH, Giacobbe P, Placenza F, Hudson CJ, Seeman P, Seeman MV (September 2014). "Depression treatment by withdrawal of short-term low-dose antipsychotic, a proof-of-concept randomized double-blind study". J Affect Disord. 166: 139–143. doi:10.1016/j.jad.2014.04.014. PMID   25012422.
  85. ↑ Cohen D, Recalt A (2019). "Discontinuing Psychotropic Drugs from Participants in Randomized Controlled Trials: A Systematic Review". Psychother Psychosom. 88 (2): 96–104. doi:10.1159/000496733. PMID   30923288.
  86. ↑ Hofmeyr JM (December 1981). "The use of haloperidol as a long-acting neuroleptic in game capture operations". Journal of the South African Veterinary Association. 52 (4): 273–282. PMID   6122740.
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