Haloperidol - Revision history

MDElliottMD: Category taxonomy (#23): retag to house-compliant neuroleptic categories

2026-05-22T14:41:24Z

Category taxonomy (#23): retag to house-compliant neuroleptic categories

← Older revision		Revision as of 14:41, 22 May 2026
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	}}		}}
	[[Category:Butyrophenones]]		[[Category:Butyrophenones]]
	[[Category:First-~~Generation Antipsychotics (FGAs / Typicals)~~]]		[[Category:First-generation neuroleptics]]
	[[Category:Neuroleptics]]		[[Category:Neuroleptics]]

MDElliottMD: Dedupe migration per interface-claude 2026-05-20: Antipsychotics / Neuroleptics merged into canonical Neuroleptics. Member retagged.

2026-05-19T18:00:17Z

Dedupe migration per interface-claude 2026-05-20: Antipsychotics / Neuroleptics merged into canonical Neuroleptics. Member retagged.

← Older revision		Revision as of 18:00, 19 May 2026
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	[[Category:Butyrophenones]]		[[Category:Butyrophenones]]
	[[Category:First-Generation Antipsychotics (FGAs / Typicals)]]		[[Category:First-Generation Antipsychotics (FGAs / Typicals)]]
	[[Category:~~Antipsychotics /~~ Neuroleptics]]		[[Category:Neuroleptics]]

MDElliottMD: Em-dash sweep: replace em-dash with comma per project rule; PendellsCorner verbatim quotes preserved.

2026-05-19T03:16:08Z

Em-dash sweep: replace em-dash with comma per project rule; PendellsCorner verbatim quotes preserved.

MDElliottMD: Comprehensive categorization: +Butyrophenones, First-Generation Antipsychotics (FGAs / Typicals), Antipsychotics / Neuroleptics

2026-05-15T18:42:08Z

Comprehensive categorization: +Butyrophenones, First-Generation Antipsychotics (FGAs / Typicals), Antipsychotics / Neuroleptics

← Older revision		Revision as of 18:42, 15 May 2026
Line 73:		Line 73:
	\| references =		\| references =
	}}		}}
			[[Category:Butyrophenones]]
			[[Category:First-Generation Antipsychotics (FGAs / Typicals)]]
			[[Category:Antipsychotics / Neuroleptics]]

MDElliottMD: Pharmacopedia: add

2026-05-14T03:30:54Z

Pharmacopedia: add <pharmaInteractions/>

← Older revision		Revision as of 03:30, 14 May 2026
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	* '''Anticholinergics''' — may reduce EPS but worsen delirium/cognition		* '''Anticholinergics''' — may reduce EPS but worsen delirium/cognition
	* '''Levodopa / dopamine agonists''' — mutual antagonism		* '''Levodopa / dopamine agonists''' — mutual antagonism
			<pharmaInteractions/>
	\| pregnancy_details = Category C. Has a long clinical track record in pregnancy and is generally considered one of the better-studied antipsychotics for use during pregnancy when treatment is necessary. Third-trimester exposure is associated with neonatal EPS and withdrawal symptoms. Occasionally used for severe hyperemesis gravidarum. Excreted in breast milk; breastfeeding generally permitted with caution.		\| pregnancy_details = Category C. Has a long clinical track record in pregnancy and is generally considered one of the better-studied antipsychotics for use during pregnancy when treatment is necessary. Third-trimester exposure is associated with neonatal EPS and withdrawal symptoms. Occasionally used for severe hyperemesis gravidarum. Excreted in breast milk; breastfeeding generally permitted with caution.
	\| monitoring = * '''Baseline ECG''' — and after dose changes, especially IV or high oral doses		\| monitoring = * '''Baseline ECG''' — and after dose changes, especially IV or high oral doses

MDElliottMD: Pharmacopedia: remove contraindications parameter

2026-05-14T02:40:36Z

Pharmacopedia: remove contraindications parameter

← Older revision		Revision as of 02:40, 14 May 2026
Line 43:		Line 43:
	* '''Lowered seizure threshold''' — caution in epilepsy		* '''Lowered seizure threshold''' — caution in epilepsy
	* '''Black box warning:''' increased mortality in elderly patients with dementia-related psychosis		* '''Black box warning:''' increased mortality in elderly patients with dementia-related psychosis
	~~\| contraindications = * Severe CNS depression or coma~~
	* Parkinson's disease (worsens motor symptoms)
	* Lewy body dementia (severe neuroleptic sensitivity — can be fatal)
	* Known QT prolongation or torsades de pointes risk
	* Hypersensitivity to haloperidol or butyrophenones
	\| interactions = * '''QT-prolonging agents''' — azoles, fluoroquinolones, methadone, ondansetron, citalopram, certain antiarrhythmics — additive risk of torsades		\| interactions = * '''QT-prolonging agents''' — azoles, fluoroquinolones, methadone, ondansetron, citalopram, certain antiarrhythmics — additive risk of torsades
	* '''CYP3A4 inhibitors''' (ketoconazole, ritonavir, clarithromycin) — elevated haloperidol levels		* '''CYP3A4 inhibitors''' (ketoconazole, ritonavir, clarithromycin) — elevated haloperidol levels

MDElliottMD at 07:42, 11 May 2026

2026-05-11T07:42:57Z

← Older revision		Revision as of 07:42, 11 May 2026
Line 1:		Line 1:
	{{MedTemplate		{{MedTemplate
	\| generic = ~~haloperidol~~		\| generic = Haloperidol
	\| brand = Haldol		\| brand = Haldol, Serenace, Haldol Decanoate
	\| structure = Haloperidol.svg		\| structure = Haloperidol.svg
	\| ~~class~~ = ~~Neuroleptic~~, ~~Antipsychotic~~		\| classes = Typical antipsychotic, Antiemetic
	\| mechanism = D2 ~~antagonism~~		\| mechanism = High-affinity D2 receptor antagonist
	\| uses = ~~Psychosis~~, agitation, ~~tics~~, ~~hiccups~~		\| uses = Schizophrenia, acute psychosis, agitation, delirium, Tourette syndrome, severe nausea
	\| formula =		\| formula = C<sub>21</sub>H<sub>23</sub>ClFNO<sub>2</sub>
	~~\| mass =~~		\| routes = Oral, IM, IV
	~~\| cas =~~		\| onset = PO 1–2 h; IM 30–60 min; IV 5–20 min
	~~\| atc =~~		\| duration = 12–24 h (oral); decanoate IM 3–4 weeks
	\| routes =		\| halflife = 14–26 h (oral); ~3 weeks (decanoate)
	\| onset =		\| bioavailability = ~60–70% (oral)
	\| duration =		\| pregnancy = Category C
	\| halflife =		\| legal = Rx-only
	\| bioavailability =		\| intro = '''Haloperidol''' is a butyrophenone-class first-generation ("typical") antipsychotic. Its defining feature is high-affinity, relatively selective D<sub>2</sub> receptor antagonism with minimal anticholinergic activity — making it one of the more behaviorally selective typicals. Despite the broader shift toward atypicals for chronic psychiatric care, haloperidol remains widely used for acute agitation, ICU and postoperative delirium, palliative care nausea, and as a long-acting depot formulation (haloperidol decanoate) for maintenance treatment of schizophrenia.
	\| pregnancy =		\| pharmacokinetics = Oral bioavailability ~60–70% (substantial first-pass); IM and IV essentially 100%. Highly protein-bound (~92%). Metabolized hepatically by '''CYP3A4''' and '''CYP2D6''' to multiple metabolites, including reduced haloperidol (slightly active and back-converts to parent). Half-life 14–26 hours orally; haloperidol decanoate has a terminal half-life of ~3 weeks, allowing every-3–4-week IM dosing for maintenance.
	\| legal =		\| pharmacodynamics = Potent D<sub>2</sub> antagonist with high D<sub>2</sub>:5-HT<sub>2A</sub> affinity ratio — the pharmacologic profile that defines a "typical" antipsychotic and underlies its extrapyramidal side effect liability. Modest α<sub>1</sub>-adrenergic and H<sub>1</sub> antagonism (less than chlorpromazine). '''Minimal muscarinic activity''' — a key advantage over low-potency typicals, but also why EPS is more prominent (no built-in anticholinergic compensation). Antiemetic effect via D<sub>2</sub> blockade at the chemoreceptor trigger zone.
	\| intro =		\| indications = * Schizophrenia — acute and maintenance (including decanoate for long-acting injectable maintenance)
	\| ~~pharmacology~~ =		* Acute psychosis from any cause
	\| ~~pharmacokinetics~~ =		* Severe acute agitation, especially hyperactive delirium
	\| indications =		* ICU and postoperative delirium (per common protocols, though evidence is contested)
	\| dosing =		* Tourette syndrome and severe tic disorders (FDA-approved)
	\| effects =		* Off-label: refractory nausea/vomiting (palliative care, chemotherapy-associated), hiccups, hyperemesis gravidarum
	\| adverse =		\| dosing = '''Acute psychosis, oral:''' 0.5–5 mg PO 2–3 times daily; titrate to 5–20 mg/day total. Max 30 mg/day in severe cases.
	\| contraindications =		'''Acute agitation, IM:''' 2–10 mg IM, may repeat every 30–60 min as needed. Lower in elderly (0.5–2 mg).
	\| interactions =		'''Delirium, IV (off-label but common):''' 0.5–5 mg IV — '''baseline ECG required'''. Lower in elderly.
	\| pregnancy_details =		'''Maintenance, decanoate IM:''' 50–300 mg every 3–4 weeks. Conversion: roughly 10–20× the daily oral dose monthly.
	\| monitoring =		'''Elderly / frail / dementia:''' start very low (0.25–0.5 mg) and titrate slowly; mortality risk in dementia-related psychosis (FDA black box).
	\| counseling =		\| effects = ''Therapeutic:'' reduction of positive psychotic symptoms (hallucinations, delusions, thought disorder), calming, reduced agitation, antiemesis.
			''Common adverse:'' '''extrapyramidal symptoms''' (acute dystonia, akathisia, parkinsonism), mild sedation, dry mouth, mild orthostatic hypotension, hyperprolactinemia.
			\| adverse = * '''Extrapyramidal symptoms (EPS)''' — the dominant adverse effect profile:
			** Acute dystonia (hours–days), especially young males; treat with IM benztropine or diphenhydramine
			** Akathisia (days–weeks); reduce dose, add propranolol or benzodiazepine
			** Parkinsonism (weeks); reduce dose, add anticholinergic
			** Tardive dyskinesia (months–years); reduce/discontinue, switch to atypical, VMAT2 inhibitor (valbenazine, deutetrabenazine)
			* '''Neuroleptic malignant syndrome''' — rare but life-threatening: hyperthermia, rigidity, autonomic instability, altered mental status, elevated CK. Stop med, supportive care, ± dantrolene/bromocriptine.
			* '''QT prolongation''' — significant; baseline ECG and electrolyte monitoring especially with IV or high doses
			* '''Hyperprolactinemia''' — galactorrhea, gynecomastia, sexual dysfunction, amenorrhea
			* '''Sedation''' — less than chlorpromazine, more than aripiprazole
			* '''Orthostatic hypotension''' — α<sub>1</sub> blockade; less than low-potency typicals
			* '''Anticholinergic effects''' — much milder than chlorpromazine
			* '''Lowered seizure threshold''' — caution in epilepsy
			* '''Black box warning:''' increased mortality in elderly patients with dementia-related psychosis
			\| contraindications = * Severe CNS depression or coma
			* Parkinson's disease (worsens motor symptoms)
			* Lewy body dementia (severe neuroleptic sensitivity — can be fatal)
			* Known QT prolongation or torsades de pointes risk
			* Hypersensitivity to haloperidol or butyrophenones
			\| interactions = * '''QT-prolonging agents''' — azoles, fluoroquinolones, methadone, ondansetron, citalopram, certain antiarrhythmics — additive risk of torsades
			* '''CYP3A4 inhibitors''' (ketoconazole, ritonavir, clarithromycin) — elevated haloperidol levels
			* '''CYP2D6 inhibitors''' (fluoxetine, paroxetine, bupropion) — elevated levels
			* '''CYP3A4 inducers''' (carbamazepine, rifampin, phenytoin) — reduced levels and possible loss of efficacy
			* '''CNS depressants''' (benzodiazepines, opioids, alcohol) — additive sedation and respiratory depression
			* '''Lithium''' — rare reports of neurotoxicity with combination
			* '''Anticholinergics''' — may reduce EPS but worsen delirium/cognition
			* '''Levodopa / dopamine agonists''' — mutual antagonism
			\| pregnancy_details = Category C. Has a long clinical track record in pregnancy and is generally considered one of the better-studied antipsychotics for use during pregnancy when treatment is necessary. Third-trimester exposure is associated with neonatal EPS and withdrawal symptoms. Occasionally used for severe hyperemesis gravidarum. Excreted in breast milk; breastfeeding generally permitted with caution.
			\| monitoring = * '''Baseline ECG''' — and after dose changes, especially IV or high oral doses
			* '''Electrolytes''' (K<sup>+</sup>, Mg<sup>2+</sup>) — for QT risk
			* '''AIMS / EPS screening''' — at baseline, periodically thereafter (every 6 months for chronic use)
			* '''Prolactin''' — if symptoms suggest hyperprolactinemia
			* '''Glucose and lipids''' — less metabolic concern than with atypicals, but check periodically
			* '''LFTs''' — at baseline and if symptoms develop
			* '''Vital signs''' — orthostatic BP at initiation
			\| counseling = * Take at the same time each day; capsule/tablet can be taken with or without food.
			* Report muscle stiffness, tremor, restlessness, or abnormal involuntary movements promptly.
			* Watch for fever + rigidity + confusion — could indicate neuroleptic malignant syndrome (medical emergency).
			* Avoid alcohol and other sedatives.
			* Use caution with driving until response to the medicine is known.
			* Hard candy or sips of water for dry mouth.
			* Rise slowly from sitting/lying to minimize dizziness.
			* Don't stop abruptly — taper if discontinuing.
			* Stay hydrated and avoid overheating; haloperidol impairs thermoregulation.
	\| anecdotes =		\| anecdotes =
	\| seealso =		\| seealso = [[Chlorpromazine]], [[Fluphenazine]], [[Perphenazine]], [[Trifluoperazine]], [[Risperidone]], [[Olanzapine]], [[Quetiapine]], [[Aripiprazole]]
	\| references =		\| references =
	}}		}}

MDElliottMD: Created page with "{{MedTemplate | generic = haloperidol | brand = Haldol | structure = Haloperidol.svg | class = Neuroleptic, Antipsychotic | mechanism = D2 antagonism | uses = Psychosis, agitation, tics, hiccups | formula = | mass = | cas = | atc = | routes = | onset = | duration = | halflife = | bioavailability = | pregnanc..."

2026-05-11T00:24:22Z

Created page with "{{MedTemplate | generic = haloperidol | brand = Haldol | structure = Haloperidol.svg | class = Neuroleptic, Antipsychotic | mechanism = D2 antagonism | uses = Psychosis, agitation, tics, hiccups | formula = | mass = | cas = | atc = | routes = | onset = | duration = | halflife = | bioavailability = | pregnanc..."

New page

{{MedTemplate
| generic = haloperidol
| brand = Haldol
| structure = Haloperidol.svg
| class = Neuroleptic, Antipsychotic
| mechanism = D2 antagonism
| uses = Psychosis, agitation, tics, hiccups
| formula =
| mass =
| cas =
| atc =
| routes =
| onset =
| duration =
| halflife =
| bioavailability =
| pregnancy =
| legal =
| intro =
| pharmacology =
| pharmacokinetics =
| indications =
| dosing =
| effects =
| adverse =
| contraindications =
| interactions =
| pregnancy_details =
| monitoring =
| counseling =
| anecdotes =
| seealso =
| references =
}}

← Older revision		Revision as of 03:16, 19 May 2026
Line 14:		Line 14:
	\| pregnancy = Category C		\| pregnancy = Category C
	\| legal = Rx-only		\| legal = Rx-only
	\| intro = '''Haloperidol''' is a butyrophenone-class first-generation ("typical") antipsychotic. Its defining feature is high-affinity, relatively selective D<sub>2</sub> receptor antagonism with minimal anticholinergic activity — making it one of the more behaviorally selective typicals. Despite the broader shift toward atypicals for chronic psychiatric care, haloperidol remains widely used for acute agitation, ICU and postoperative delirium, palliative care nausea, and as a long-acting depot formulation (haloperidol decanoate) for maintenance treatment of schizophrenia.		\| intro = '''Haloperidol''' is a butyrophenone-class first-generation ("typical") antipsychotic. Its defining feature is high-affinity, relatively selective D<sub>2</sub> receptor antagonism with minimal anticholinergic activity, making it one of the more behaviorally selective typicals. Despite the broader shift toward atypicals for chronic psychiatric care, haloperidol remains widely used for acute agitation, ICU and postoperative delirium, palliative care nausea, and as a long-acting depot formulation (haloperidol decanoate) for maintenance treatment of schizophrenia.
	\| pharmacokinetics = Oral bioavailability ~60–70% (substantial first-pass); IM and IV essentially 100%. Highly protein-bound (~92%). Metabolized hepatically by '''CYP3A4''' and '''CYP2D6''' to multiple metabolites, including reduced haloperidol (slightly active and back-converts to parent). Half-life 14–26 hours orally; haloperidol decanoate has a terminal half-life of ~3 weeks, allowing every-3–4-week IM dosing for maintenance.		\| pharmacokinetics = Oral bioavailability ~60–70% (substantial first-pass); IM and IV essentially 100%. Highly protein-bound (~92%). Metabolized hepatically by '''CYP3A4''' and '''CYP2D6''' to multiple metabolites, including reduced haloperidol (slightly active and back-converts to parent). Half-life 14–26 hours orally; haloperidol decanoate has a terminal half-life of ~3 weeks, allowing every-3–4-week IM dosing for maintenance.
	\| pharmacodynamics = Potent D<sub>2</sub> antagonist with high D<sub>2</sub>:5-HT<sub>2A</sub> affinity ratio — the pharmacologic profile that defines a "typical" antipsychotic and underlies its extrapyramidal side effect liability. Modest α<sub>1</sub>-adrenergic and H<sub>1</sub> antagonism (less than chlorpromazine). '''Minimal muscarinic activity''' — a key advantage over low-potency typicals, but also why EPS is more prominent (no built-in anticholinergic compensation). Antiemetic effect via D<sub>2</sub> blockade at the chemoreceptor trigger zone.		\| pharmacodynamics = Potent D<sub>2</sub> antagonist with high D<sub>2</sub>:5-HT<sub>2A</sub> affinity ratio, the pharmacologic profile that defines a "typical" antipsychotic and underlies its extrapyramidal side effect liability. Modest α<sub>1</sub>-adrenergic and H<sub>1</sub> antagonism (less than chlorpromazine). '''Minimal muscarinic activity''', a key advantage over low-potency typicals, but also why EPS is more prominent (no built-in anticholinergic compensation). Antiemetic effect via D<sub>2</sub> blockade at the chemoreceptor trigger zone.
	\| indications = * Schizophrenia — acute and maintenance (including decanoate for long-acting injectable maintenance)		\| indications = * Schizophrenia, acute and maintenance (including decanoate for long-acting injectable maintenance)
	* Acute psychosis from any cause		* Acute psychosis from any cause
	* Severe acute agitation, especially hyperactive delirium		* Severe acute agitation, especially hyperactive delirium
Line 25:		Line 25:
	\| dosing = '''Acute psychosis, oral:''' 0.5–5 mg PO 2–3 times daily; titrate to 5–20 mg/day total. Max 30 mg/day in severe cases.		\| dosing = '''Acute psychosis, oral:''' 0.5–5 mg PO 2–3 times daily; titrate to 5–20 mg/day total. Max 30 mg/day in severe cases.
	'''Acute agitation, IM:''' 2–10 mg IM, may repeat every 30–60 min as needed. Lower in elderly (0.5–2 mg).		'''Acute agitation, IM:''' 2–10 mg IM, may repeat every 30–60 min as needed. Lower in elderly (0.5–2 mg).
	'''Delirium, IV (off-label but common):''' 0.5–5 mg IV — '''baseline ECG required'''. Lower in elderly.		'''Delirium, IV (off-label but common):''' 0.5–5 mg IV, '''baseline ECG required'''. Lower in elderly.
	'''Maintenance, decanoate IM:''' 50–300 mg every 3–4 weeks. Conversion: roughly 10–20× the daily oral dose monthly.		'''Maintenance, decanoate IM:''' 50–300 mg every 3–4 weeks. Conversion: roughly 10–20× the daily oral dose monthly.
	'''Elderly / frail / dementia:''' start very low (0.25–0.5 mg) and titrate slowly; mortality risk in dementia-related psychosis (FDA black box).		'''Elderly / frail / dementia:''' start very low (0.25–0.5 mg) and titrate slowly; mortality risk in dementia-related psychosis (FDA black box).
	\| effects = ''Therapeutic:'' reduction of positive psychotic symptoms (hallucinations, delusions, thought disorder), calming, reduced agitation, antiemesis.		\| effects = ''Therapeutic:'' reduction of positive psychotic symptoms (hallucinations, delusions, thought disorder), calming, reduced agitation, antiemesis.
	''Common adverse:'' '''extrapyramidal symptoms''' (acute dystonia, akathisia, parkinsonism), mild sedation, dry mouth, mild orthostatic hypotension, hyperprolactinemia.		''Common adverse:'' '''extrapyramidal symptoms''' (acute dystonia, akathisia, parkinsonism), mild sedation, dry mouth, mild orthostatic hypotension, hyperprolactinemia.
	\| adverse = * '''Extrapyramidal symptoms (EPS)''' — the dominant adverse effect profile:		\| adverse = * '''Extrapyramidal symptoms (EPS)''', the dominant adverse effect profile:
	** Acute dystonia (hours–days), especially young males; treat with IM benztropine or diphenhydramine		** Acute dystonia (hours–days), especially young males; treat with IM benztropine or diphenhydramine
	** Akathisia (days–weeks); reduce dose, add propranolol or benzodiazepine		** Akathisia (days–weeks); reduce dose, add propranolol or benzodiazepine
	** Parkinsonism (weeks); reduce dose, add anticholinergic		** Parkinsonism (weeks); reduce dose, add anticholinergic
	** Tardive dyskinesia (months–years); reduce/discontinue, switch to atypical, VMAT2 inhibitor (valbenazine, deutetrabenazine)		** Tardive dyskinesia (months–years); reduce/discontinue, switch to atypical, VMAT2 inhibitor (valbenazine, deutetrabenazine)
	* '''Neuroleptic malignant syndrome''' — rare but life-threatening: hyperthermia, rigidity, autonomic instability, altered mental status, elevated CK. Stop med, supportive care, ± dantrolene/bromocriptine.		* '''Neuroleptic malignant syndrome''', rare but life-threatening: hyperthermia, rigidity, autonomic instability, altered mental status, elevated CK. Stop med, supportive care, ± dantrolene/bromocriptine.
	* '''QT prolongation''' — significant; baseline ECG and electrolyte monitoring especially with IV or high doses		* '''QT prolongation''', significant; baseline ECG and electrolyte monitoring especially with IV or high doses
	* '''Hyperprolactinemia''' — galactorrhea, gynecomastia, sexual dysfunction, amenorrhea		* '''Hyperprolactinemia''', galactorrhea, gynecomastia, sexual dysfunction, amenorrhea
	* '''Sedation''' — less than chlorpromazine, more than aripiprazole		* '''Sedation''', less than chlorpromazine, more than aripiprazole
	* '''Orthostatic hypotension''' — α<sub>1</sub> blockade; less than low-potency typicals		* '''Orthostatic hypotension''', α<sub>1</sub> blockade; less than low-potency typicals
	* '''Anticholinergic effects''' — much milder than chlorpromazine		* '''Anticholinergic effects''', much milder than chlorpromazine
	* '''Lowered seizure threshold''' — caution in epilepsy		* '''Lowered seizure threshold''', caution in epilepsy
	* '''Black box warning:''' increased mortality in elderly patients with dementia-related psychosis		* '''Black box warning:''' increased mortality in elderly patients with dementia-related psychosis
	\| interactions = * '''QT-prolonging agents''' — azoles, fluoroquinolones, methadone, ondansetron, citalopram, certain antiarrhythmics — additive risk of torsades		\| interactions = * '''QT-prolonging agents''', azoles, fluoroquinolones, methadone, ondansetron, citalopram, certain antiarrhythmics, additive risk of torsades
	* '''CYP3A4 inhibitors''' (ketoconazole, ritonavir, clarithromycin) — elevated haloperidol levels		* '''CYP3A4 inhibitors''' (ketoconazole, ritonavir, clarithromycin), elevated haloperidol levels
	* '''CYP2D6 inhibitors''' (fluoxetine, paroxetine, bupropion) — elevated levels		* '''CYP2D6 inhibitors''' (fluoxetine, paroxetine, bupropion), elevated levels
	* '''CYP3A4 inducers''' (carbamazepine, rifampin, phenytoin) — reduced levels and possible loss of efficacy		* '''CYP3A4 inducers''' (carbamazepine, rifampin, phenytoin), reduced levels and possible loss of efficacy
	* '''CNS depressants''' (benzodiazepines, opioids, alcohol) — additive sedation and respiratory depression		* '''CNS depressants''' (benzodiazepines, opioids, alcohol), additive sedation and respiratory depression
	* '''Lithium''' — rare reports of neurotoxicity with combination		* '''Lithium''', rare reports of neurotoxicity with combination
	* '''Anticholinergics''' — may reduce EPS but worsen delirium/cognition		* '''Anticholinergics''', may reduce EPS but worsen delirium/cognition
	* '''Levodopa / dopamine agonists''' — mutual antagonism		* '''Levodopa / dopamine agonists''', mutual antagonism
	<pharmaInteractions/>		<pharmaInteractions/>
	\| pregnancy_details = Category C. Has a long clinical track record in pregnancy and is generally considered one of the better-studied antipsychotics for use during pregnancy when treatment is necessary. Third-trimester exposure is associated with neonatal EPS and withdrawal symptoms. Occasionally used for severe hyperemesis gravidarum. Excreted in breast milk; breastfeeding generally permitted with caution.		\| pregnancy_details = Category C. Has a long clinical track record in pregnancy and is generally considered one of the better-studied antipsychotics for use during pregnancy when treatment is necessary. Third-trimester exposure is associated with neonatal EPS and withdrawal symptoms. Occasionally used for severe hyperemesis gravidarum. Excreted in breast milk; breastfeeding generally permitted with caution.
	\| monitoring = * '''Baseline ECG''' — and after dose changes, especially IV or high oral doses		\| monitoring = * '''Baseline ECG''', and after dose changes, especially IV or high oral doses
	* '''Electrolytes''' (K<sup>+</sup>, Mg<sup>2+</sup>) — for QT risk		* '''Electrolytes''' (K<sup>+</sup>, Mg<sup>2+</sup>), for QT risk
	* '''AIMS / EPS screening''' — at baseline, periodically thereafter (every 6 months for chronic use)		* '''AIMS / EPS screening''', at baseline, periodically thereafter (every 6 months for chronic use)
	* '''Prolactin''' — if symptoms suggest hyperprolactinemia		* '''Prolactin''', if symptoms suggest hyperprolactinemia
	* '''Glucose and lipids''' — less metabolic concern than with atypicals, but check periodically		* '''Glucose and lipids''', less metabolic concern than with atypicals, but check periodically
	* '''LFTs''' — at baseline and if symptoms develop		* '''LFTs''', at baseline and if symptoms develop
	* '''Vital signs''' — orthostatic BP at initiation		* '''Vital signs''', orthostatic BP at initiation
	\| counseling = * Take at the same time each day; capsule/tablet can be taken with or without food.		\| counseling = * Take at the same time each day; capsule/tablet can be taken with or without food.
	* Report muscle stiffness, tremor, restlessness, or abnormal involuntary movements promptly.		* Report muscle stiffness, tremor, restlessness, or abnormal involuntary movements promptly.
	* Watch for fever + rigidity + confusion — could indicate neuroleptic malignant syndrome (medical emergency).		* Watch for fever + rigidity + confusion, could indicate neuroleptic malignant syndrome (medical emergency).
	* Avoid alcohol and other sedatives.		* Avoid alcohol and other sedatives.
	* Use caution with driving until response to the medicine is known.		* Use caution with driving until response to the medicine is known.
	* Hard candy or sips of water for dry mouth.		* Hard candy or sips of water for dry mouth.
	* Rise slowly from sitting/lying to minimize dizziness.		* Rise slowly from sitting/lying to minimize dizziness.
	* Don't stop abruptly — taper if discontinuing.		* Don't stop abruptly, taper if discontinuing.
	* Stay hydrated and avoid overheating; haloperidol impairs thermoregulation.		* Stay hydrated and avoid overheating; haloperidol impairs thermoregulation.
	\| anecdotes =		\| anecdotes =