Haloperidol is a drug that belongs to the group of antipsychotics. It is one of the first antipsychotic drugs. Today, a huge number of new medications are being developed, but their effectiveness in trials is always compared with the effect of haloperidol.
In medical practice, the medicine is actively used by psychiatrists in the treatment of various neurological diseases and mental disorders.
Release form and composition
Haloperidol is a typical antipsychotic. The active substance in the medicine is a butyrophenone derivative of the same name. The medicine is produced in various forms, which allows you to accurately select the required dosage.
The most popular products are for oral use: tablets and concentrate. A second form of the medication is also available as a nasal spray. Tablets can be purchased in different dosages - 1.5 mg or 5.0 mg.
Haloperidol is produced in the form of a short-acting solution, which is intended for intramuscular and intravenous administration. In addition, a long-acting medicine is offered, which is administered intramuscularly and maintains its effect for 3 weeks.
What is this
An antipsychotic drug made from butyrophenone, it has a powerful sedative and antipsychotic effect. It has quite a few side effects, but as an alternative to lobotomy it is quite good, and many patients are successfully treated with it, work and are generally socially adapted, although there are more pleasant analogues (see below).
Other antipsychotics
Haloperidol is a classic of psychiatry, which, although it has become an anachronism, is successfully used, along with the even more ancient Aminazine, to this day, for lack of a better one, in cases of emergency psychiatric care, especially to calm indignant transcendentals.
Now there are atypical antipsychotics, devoid of some of the negative effects of their predecessors, but they are also fashionable and modern: a pack of Aripiprazole (Abilify) will cost about 7,000 rubles. This is 28 tablets, and you need to take it constantly, otherwise there is a risk of falling back into communication with the gods. They act more selectively, preserving a little more brain in patients.
Impact
The therapeutic effect of haloperidol is associated with the substance’s ability to block dopamine receptors, as well as inhibit adrenaline and adrenergic receptors in the brain. This makes it possible to normalize human behavior in mental disorders. In addition, the drug has an antiemetic effect.
While taking the drug it is possible to:
- Reduce physical activity.
- Remove signs of aggression.
- Elimination of hallucinations and mania.
- Increase interest in the world around you.
The maximum concentration of the active substance is achieved:
- After oral use after 3-6 hours.
- After intramuscular injection of a short-acting drug, after 10-20 minutes,
- After intramuscular administration of a prolonged drug after 3-9 days.
Symptoms
Haloperidol withdrawal syndrome is accompanied by specific symptoms. Anxiety and stress during cessation of treatment with antipsychotic drugs increase the risk of developing pathology or aggravate its course. Let's consider the key clinical manifestations of withdrawal syndrome.
Hypersensitivity psychosis
The condition is associated with increased sensitivity of dopamine receptors. The reaction is caused by an exacerbation of the primary mental disorder for which treatment with Haloperidol was carried out. Often, dopamine receptor hypersensitivity psychosis is combined with other pathologies, for example, tardive dyskinesia. The main symptoms are increased excitability, irritability, and outbursts of aggression. Laboratory tests often show an increase in the level of prolactin in the blood. The risk of hypersensitivity psychosis persists for several months after discontinuation of Haloperidol.
Tardive dyskinesia
It develops against the background of increased resistance of dopamine receptors in the nigrostriatal zone of the central nervous system due to prolonged treatment with antipsychotics and an imbalance between the levels of dopamine and acetylcholine in the basal ganglia. The clinical picture is characterized by dystonic or choreiform dyskinesias, withdrawal akathisia, etc.
The main symptoms are involuntary movements of the limbs and muscles in the form of nervous tics, tremor, trembling, and muscle spasms. Patients may blink frequently, repeat chewing movements, smack their lips, and unusual vocalizations and spasmodic torticollis are less common. Loss of motor control and frequent seizures complicate the problem. Tardive dyskinesia is diagnosed 2-3 days after stopping treatment.
Cholinergic rebound syndrome
Develops in response to abrupt withdrawal of Haloperidol. The condition occurs in response to an increase in the resistance of not only dopamine but also muscurinic receptors. Key symptoms are nausea, increased anxiety, sleep disorders and extrapyramidal disorders.
Cholinergic rebound syndrome may occur in patients taking antipsychotics concomitantly with anticholinergic drugs. This combination makes it possible to correct the side effects of neuroleptic therapy. The condition is prevented by slow withdrawal of Haloperidol and taking anticholinergic drugs for 1-2 weeks after stopping treatment.
"Early activation"
A relatively new term in psychiatry, meaning increased motor and mental activity in response to abrupt withdrawal of Haloperidol. The clinical picture of “early activation” is based on the withdrawal of the antipsychotic drug and the associated blockade of histamine H1 receptors. The main symptoms are aggression towards others, insomnia, excess energy.
Typically, the listed manifestations were regarded as a stimulating effect of the new drug and signs of worsening psychosis, which is extremely undesirable for patients. But at the same time, “early activation” must also be considered from the point of view of stopping treatment with Haloperidol as a negative consequence of withdrawal syndrome. That is, a differential diagnosis of “early activation” and psychomotor agitation, akathisia, and suppression of the sedative effect on the central nervous system is necessary.
Nonspecific clinical picture
Sometimes the symptoms of Haloperidol withdrawal syndrome are not similar to the clinical manifestations listed above. Experts explain this phenomenon by the individual reaction of the central nervous system to drug withdrawal. Patients complain of headaches and dizziness, problems with the functioning of the gastrointestinal tract, sweating and weakness. Most often, withdrawal syndrome is observed in the first 4-7 days after stopping the drug. Its maximum duration is 4 weeks. The severity of manifestations depends on the duration of treatment with Haloperidol. Sometimes pathology occurs after a short course of treatment.
When is haloperidol prescribed?
Haloperidol, the instructions for use indicate this, is often prescribed orally or intramuscularly for psychoses of various origins. It helps stabilize the condition of patients suffering from:
- Manic disorders, characterized by increased levels of agitation and an inability to control behavior.
- Oligophrenia, the symptom of which is mental retardation.
- Schizophrenia, the symptoms of which are fundamental disturbances in the perception of the surrounding world.
- Paranoia, the symptom of which is excessive suspicion.
Neuroleptic treatment haloperidol, the instructions focus on this, indicated for
Gilles de la Tourette syndrome. This genetic disorder is characterized by uncontrollable multiple vocal and motor tics.
The drug is indicated for the development of Huntington's chorea. This is a hereditary, constantly progressive disease, which is manifested by a gradual deterioration of speech, memory and involuntary unusual movements that complicate daily activities.
The drug is prescribed for various psychosomatic disorders and behavioral disorders in the elderly and children. The medicine is effective in the prevention and treatment of nausea and vomiting that occurs during chemotherapy.
Carbamazepine
It is effective against all symptoms when withdrawing from binge drinking and can be the drug of choice when interrupting mild to moderate binge drinking. The lack of interaction with alcohol allows the drug to be used even if it is present in the blood. It has been established that Carbamazepine affects the neuronal transmission of GABA, glutamate, norepinephrine, acetylcholine and dopamine. Monotherapy with carbamazepine is effective for mild to moderate withdrawal syndrome; for severe withdrawal, benzodiazepines are recommended. The undoubted advantage of carbamazepine is the absence of a euphoric effect and the risk of dependence on the drug.
Terms of use
The peculiarity of haloperidol treatment is that the medicine is always initially prescribed in minimal doses: 0.5-5 mg 2-3 times a day. The dosage for older people is reduced to 2 mg. Depending on the reaction of the patient’s body and the results obtained, the dose of the drug is gradually increased to 5-10 mg per day.
Other recommendations:
- When administered intramuscularly, the initial single dose is 1-10 mg, repeated injection is possible after 1-8 hours.
- When administered intravenously, the initial single dose is 0.5-50 mg, repeated injection is prescribed depending on the indications and condition of the patient.
- When using a long-acting dosage form, the medicine is administered at a dose of 50-300 mg once every 4 weeks.
During treatment with haloperidol, the patient's condition must be monitored. If a positive stable result is recorded, the drug is discontinued.
Use of the drug in the clinic
The medicine is used for short-term use, only in specialized clinics. The features of its use are as follows:
- the dosage is selected by the doctor individually, starting with small doses;
- the patient is monitored 24 hours a day in the hospital during admission;
- Physiological functions (pressure, body temperature, glucose levels, etc.) are regularly monitored;
- doctors and nurses keep a sheet recording the patient’s condition;
- The attending physician additionally prescribes medications that protect against the side effects of the antipsychotic.
Haloperidol is discontinued as soon as the patient's condition has stabilized. Long-term use is possible only in case of resistant schizophrenia, when the patient’s delusions and hallucinations do not disappear.
Contraindications and side effects
The main contraindication for the antipsychotic drug is hypersensitivity to haloperidol. It is strictly forbidden to treat children under 7 years of age. Since studies of the effect of the drug on the fetus and newborn child have not been carried out by women during pregnancy and breastfeeding, they should also not take the drug.
Other contraindications and restrictions for taking the drug are indicated in the instructions for use. You also need to carefully study all possible adverse reactions of the body. If any negative manifestations occur, treatment with this antipsychotic should be discontinued.
Overdose is very dangerous. It can provoke severe extrapyramidal disorders, manifested by movement disorders. Also, with an overdose, the risks of developing arterial hypotension increase. Other characteristic symptoms are drowsiness and lethargy. In severe cases, coma, respiratory depression, and shock occur. There is no antidote to eliminate the symptoms of an overdose, so measures are taken that are aimed at eliminating the symptoms.
Haloperidol drops, solution and tablets can be purchased at an affordable price, but only with a prescription. Numerous reviews confirm the effectiveness of treatment with the drug when indicated. The risks of side effects increase if medical recommendations are violated.
Interaction with alcohol
Any medications should absolutely not be combined with alcohol. In the case of haloperidol, this combination can lead to the most unexpected consequences. Often in such cases there are:
- a sharp increase in painful symptoms;
- disorders of the cardiovascular system;
- enhancing personal changes;
- depression of respiratory functions, which leads to coma and death;
- disorientation in space and time.
While being treated with this antipsychotic, you should not drive, engage in activities that require increased concentration, or operate machinery that requires complex maintenance.
Haloperidol is an effective antipsychotic that is widely used in alcoholic psychosis. It can only be used as prescribed by a doctor in specialized institutions that treat alcoholism and drug addiction.
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Haloperidol in the treatment of drug addiction
Acute psychoses occur due to the use of narcotic substances (or medications taken for intoxication). Acute psychosis is a short-term and pronounced surge of inappropriate behavior that does not correspond to reality. An example of acute psychosis is alcoholic delirium tremens, which is accompanied by delirium, hallucinations of a threatening nature (devils, spiders, etc.), chills and fever. Doses of haloperidol are used against the symptoms of such psychoses.
Unfortunately, this medicine only helps to remove external manifestations, but does not cure addiction and does not eliminate the consequences of use on the mind. For example, if a person addicted to cocaine is offered another substance that will alleviate his condition, he will “switch” to it.
