| Psychotic disorders; short-term treatment of generalized non-psychotic anxiety (label-dependent). View labelExact | Anxiety (non-psychotic): label describes a usual dosage of 1–2 mg twice daily and states not to exceed 6 mg/day or use longer than 12 weeks (label). | High-potency phenothiazine first-generation antipsychotic (D2 antagonism). Has a label indication for short-term treatment of non-psychotic anxiety, but carries antipsychotic-class risks including tardive dyskinesia. | Hepatic metabolism | No | | - Movement symptoms (akathisia, rigidity, tremor; tardive dyskinesia screening).
- Sedation and orthostatic symptoms (falls risk).
- Hyperprolactinemia symptoms (amenorrhea, galactorrhea, sexual dysfunction).
- Duration limits when used for non-psychotic anxiety (≤12 weeks per label).
- Reassess anxiety benefit early and document a stop plan (label/clinical).
| No | 2026-02-22 |
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| Schizophrenia; severe behavior disorders; Tourette's syndrome (tics/vocal utterances); adjunct in acute agitation. View labelExact | Schizophrenia (oral): initiate 1–5 mg two or three times daily; maintenance 5–20 mg/day divided; doses >30 mg/day increase EPS risk. | Potent dopamine D2 receptor antagonist; minimal anticholinergic. | CYP3A4, CYP2D6 | Steady-state mean 21 h | No | | - Extrapyramidal symptoms are monitored periodically; prophylaxis is generally reserved for clear need.
- QTc: ECG monitoring is often considered when risk factors or higher doses are present.
- LAI: Haloperidol decanoate every 4 weeks—product-specific conversion guidance is typically used.
- Regular AIMS screening for tardive dyskinesia (typically every 3–6 months; every 3 months in higher-risk groups or with dose increases).
- Prolactin-related symptoms (sexual dysfunction, amenorrhea, galactorrhea) and overall quality-of-life impact—consider switching if persistent.
- Orthostatic vitals and falls risk, especially in older adults and when combined with other CNS depressants or antihypertensives.
- Metabolic monitoring (weight/BMI, glucose, lipids) periodically as part of comprehensive schizophrenia care, even though metabolic risk is lower than many SGAs.
| q4wk | 2026-03-31 |
|---|
| Schizophrenia (adults) View labelExact | Initiate 4–8 mg BID/TID; titrate to 12–24 mg/day in divided doses (max 64 mg/day). | Mid-potency phenothiazine antipsychotic antagonizing dopamine D2 and serotonin 5-HT2A receptors with moderate anticholinergic activity. | CYP2D6, CYP1A2, CYP3A4 | Single-dose mean 10 h; Steady-state mean 12 h | No | - Weight
- Sedation
- EPS
- Prolactin
| - Baseline and ongoing EPS monitoring (Simpson–Angus/Barnes scales as available) and AIMS screening every 3–6 months for tardive dyskinesia.
- Weight/BMI and metabolic labs periodically even with lower metabolic risk, because sedation and appetite changes can still affect weight.
- Orthostatic vitals during titration and after medication changes, especially in older adults and with antihypertensive co-therapy.
- ECG monitoring when cardiac disease, electrolyte abnormalities, higher doses, or QT-active co-medications are present.
- Prolactin-related symptoms (sexual dysfunction, galactorrhea, amenorrhea) and overall quality-of-life impact—consider switching if persistent.
- Sedation, cognition, and falls risk; adjust dose timing and reassess driving/occupational safety after dose changes.
| No | 2025-09-26 |
|---|
| Schizophrenia; acute mania or mixed episodes (bipolar I) as monotherapy or adjunct; irritability associated with autistic disorder. View labelExact | Schizophrenia (adults): start 1–2 mg/day; increase by 1–2 mg/day to 4–6 mg/day (doses >6 mg/day increase EPS). | Dopamine D2 and serotonin 5‑HT2A receptor antagonism; also alpha‑1 and H1 activity. | CYP2D6 | Single-dose mean 3 h; Steady-state mean 21 h | No | - Weight
- Sedation
- EPS
- Prolactin
| - Metabolic: weight/BMI, fasting glucose/HbA1c, and lipids (baseline and periodic).
- EPS: monitor akathisia/parkinsonism; periodic AIMS for tardive dyskinesia.
- Prolactin: monitor for symptoms (amenorrhea, galactorrhea, sexual dysfunction).
- Sedation: assess next-day impairment and fall risk, especially with other sedatives.
| q2wk; Monthly (q4wk); q4wk or q8wk (by dose) | 2025-12-28 |
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