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Re: Thoughts on Haldol for schizoaffective?

Posted by ed_uk2010 on December 1, 2013, at 12:37:37

In reply to Thoughts on Haldol for schizoaffective?, posted by Danielj on December 1, 2013, at 10:54:39

Haloperidol (Haldol) can sometimes work just as well as newer antipsychotics. Some pts respond better to it.

The issue with haloperidol is that the risk of movement disorders is very high. Young people such as your son are particularly at risk of sustained involuntary muscle contractions (dystonia) and physical restlessness (akathisia). These side effects can develop after the first dose on otherwise early in treatment. Like Phillipa said, many pts require additional medication to reduce these side effects. They are sometimes prescribed in advance in case they are necessary (there are several to choose from).

Older pts on haloperidol often develop slowness of movement and tremor (Parkinsonism) and involuntary repetitive twitching movements, especially around the face (tardive dyskinesia). Tardive dyskinesia is usually the only side effect which can be permanent. Other side effects generally disappear on stopping or reducing the dose. Parkinsonism is much less common in young people on haloperidol, as is tardive dyskinesia. The risk of tardive dyskinesia increases with the duration of treatment; it is very rare after short-term use.

All of the above side effects can occur with other antipsychotics, but they are more common with haloperidol.

Haloperidol causes much less weight gain than most other antipsychotics. Apart from movement disorders, other side effects are generally milder than related meds.

In order to minimise the risk of adverse effects, the minimum effective dose should be found. Like you say, 10mg worked before, and will probably work again, but a lower dose could be tried eg. 5mg. Close monitoring is important for the purpose of monitoring efficacy, side effects and dose adjustments.

 

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poster:ed_uk2010 thread:1055156
URL: http://www.dr-bob.org/babble/20131115/msgs/1055162.html