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Psychotropic Use during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Large doses of haloperidol in pregnant animals and adverse fetal effects and pregnancy losses have been reported (Druga et al., 1980; Gill et al., 1982; Szabo and Brent, 1974), but not at lower doses (Bertelli et al., 1968; Hamada and Hashiguchi, 1978). As noted throughout this volume, the relevance of animal studies to safety of drugs in human pregnancy is inconsistent and not reliably predictive.
Delirium
Published in Henry J. Woodford, Essential Geriatrics, 2022
If medication is tried for symptom control in delirium, practical issues need to be considered. Patients with severe distress or at risk of harm to themselves or others (e.g. violence) are unlikely to readily take oral medication. The focus of their care may become solely based on trying to persuade them to take a tablet, which may fuel any ideas of persecution and reduce the opportunity for alternative interventions. Once swallowed, drugs take time to have an effect, probably several hours. In a time of crisis, this may not help and, given the natural fluctuation in delirium severity, it may be too late anyway. When used, low doses (e.g. haloperidol 0.25–0.5 mg once or twice a day) and short durations (e.g. one or two days) are recommended.18 There is an additional risk of people going home on medication started in hospital.
Neurologic disorders in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Robert Burger, Terry Rolan, David Lardizabal, Upinder Dhand, Aarti Sarwal, Pradeep Sahota
Rarely, abnormal movements known as choreas appear during gestation, typically following the first trimester known as chorea gravidarum. The chorea is generally seen only on half of the body and is known as a hemichorea. The incidence is said to be 1:139,000 pregnancies (76). It was previously associated with rheumatic fever; however, in the United States, the virtual elimination of this disorder has made this association less likely. More often now, it is linked to systemic lupus erythematosus or anti-phospholipid antibody syndrome (77,78). The chorea typically resolves spontaneously, often after delivery. Rarely, the movements are so severe as to induce rhabdomyolysis and hyperthermia (79). Treatment is typically by using dopamine receptor blockers. Due to concerns involving the fetus, haloperidol is preferred since of all of the medications available, it is the least likely to cause harm (80). Similar choreiform movements may occur following institution of birth control pills as well. These typically resolve after discontinuation of OC pills.
More than a Half-Century with Haloperidol: Glories, Disparities, and Use Today
Published in Issues in Mental Health Nursing, 2023
These days, it might be difficult to imagine the initial glory of haloperidol, but it was a sensation in the realms of psychiatry and mental health (Seeman, 2021; Tyler et al., 2017). It is now thought the medication aided in understanding how dopaminergic changes result in the desired effects of antipsychotics, paving the way for many medications to come; haloperidol also probably furthered the biochemistry understanding of psychosis and schizophrenia spectrum disorders, helping kickstart the dopamine hypothesis of schizophrenia (Tyler et al., 2017; Seeman, 2021). Additionally, in the first decades of use, the antipsychotic effects of haloperidol may have offered relief to so many individuals that it was a major player in accelerating deinstitutionalization, which ultimately occurred across the United States (Tyler et al., 2017).
Current and emerging pharmacotherapeutic strategies for Tourette syndrome
Published in Expert Opinion on Pharmacotherapy, 2022
Among the first-generation antidopaminergic medications, haloperidol was the first agent that proved effective for the treatment of tics back in the 1960s. As well as being a potent dopamine antagonist of the dopamine D2 receptors, haloperidol blocks both muscarinic receptors and adrenergic receptors. Its effectiveness in tic reduction is well established [39]. However, haloperidol is also notoriously associated with dose-dependent adverse effects, particularly sedation, apathy, anhedonia, hyperprolactinemia, and extrapyramidal symptoms [22]. As a consequence, the use of haloperidol for the treatment of TS has progressively decreased over the last few decades from being a first-line agent to being used only in selected cases who are characterized by severe tics that failed to respond to other interventions [28,29].
Pharmacological management of cannabinoid hyperemesis syndrome: an update of the clinical literature
Published in Expert Opinion on Pharmacotherapy, 2022
Guillermo Burillo-Putze, John R. Richards, Consuelo Rodríguez-Jiménez, Alejandro Sanchez-Agüera
Haloperidol is a butyrophenone antipsychotic primarily used in psychiatry. However, it is also an effective antiemetic from its antagonism of chemoreceptor trigger zone dopaminergic D2 receptors [114]. Several cases of resolution of acute CHS symptoms after administration of haloperidol, at intravenous and intramuscular doses between 2.5 and 5 mg, have been reported [115,116]. Another mechanism could be tied to haloperidol’s sedative properties, which counter excessive sympathetic nervous system stimulation [64,65]. Haloperidol injection is not FDA-approved for intravenous administration. Although it is recommended to be administered intramuscularly, if given intravenously, an ECG should be monitored for QT prolongation and arrhythmias. However, in the systematic review by Beach et al., no clear evidence was found to suggest that intravenous application carries greater risk for QT prolongation or torsades de pointes than other antipsychotics [117].