Dr. Bob's Psychopharmacology Tips

Rapid neuroleptization

From: MHeaney831@aol.com
Date: Wed, 1 May 1996 11:48:36 -0400
Subject: Rapid neuroleptization

I am working with a population requiring rapid medication. I have tried 3 shots (100 mg each) of haloperidol (Haldol) decanoate over ten days and got good results.

From: "McGough, James J." <JMCGOUGH@npih.medsch.ucla.edu>
Date: Wed, 01 May 96 11:24:00 PDT
Subject: Rapid neuroleptization

Evidence has been clear for at least ten years that "rapid neuroleptization" is ineffective. Administration of high dose, high potency neuroleptics succeeds in sedating patients, but does little to address rapidly the underlying psychosis. There also exists a theoretical increase in risk for long-term side-effects.

A very effective technique for rapid sedation in psychotic agitation is combination therapy with haloperidol & lorazepam. I generally use doses of 5 mg Haldol & 2 mg Ativan i.m. q30-60 minutes. Generally patients exhibit a good response within one or two doses. I would never give more than 20 mg haldol/24 hours -- and virtually never need to.

Once stable, you can decrease daily doses of either medicine as indicated clinically.

Date: Wed, 1 May 1996 21:13:59 -0400 (EDT)
From: David Tobolowsky <dmtmd@dcfreenet.seflin.lib.fl.us>
Subject: Rapid neuroleptization

I prefer to administer antipsychotic plus benzodiazepine to avoid risks of high-dose antipsychotics (with haloperidol, you may exceed a therapeutic window).

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