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Haloperidol: instructions Cautions

The subject of research in this article is the drug "Haloperidol", the instructions for which are taken as the basis of the material.

Haloperidol (Haloperidol), Haloperidol Decanoate (for injections), Haloperidol in drops is by far the most powerful psychotropic drug with a wide spectrum of action. It has an honorable age in the history of treatment of the most severe mental and neurological diseases - 55 years (developed and tested in Belgium by Janssen Pharmaceuticals in 1957).

The substance belongs to the group of antipsychotics or antipsychotics. So they called him until a new generation of antipsychotics (antipsychotics) appeared in the pharmacology and pharmaceuticals of the 1990s. After that, Haloperidol was called the typical antipsychotic (TH) or typical antipsychotic (TA). New generation drugs (for example, Seroquel, Olanzapine, etc.) are called atypical antipsychotics (AN) or atypical antipsychotics (AA). The difference between the generations of these drugs is perhaps revolutionary in medicine. It is important to understand how dangerous Haloperidol is. The side effects that he possesses sometimes lead to additional diseases that require separate treatment.

In some AA (Seroquel), these side effects have not yet been detected.

Haloperidol, the instructions for which are discussed in this material, have a truly huge range of actions. It is enough only to list the diseases that are treated with its use, so that the crucial importance that it has in medical practice becomes apparent.

Haloperidol is used in the following cases :

  • Psychomotor agitation of various origins: mania (overexcitation with the commission of dangerous acts), cases of oligophrenia (mental retardation), psychopathy (diseases of cognition and behavior), schizophrenia (the most severe of the known mental illnesses), chronic alcoholism;
  • Delusional disorders (inability to distinguish the real world from imaginary reality);
  • Hallucinatory disorders (absolute belief in delusional auditory or visual phenomena of reality, which actually does not exist);
  • The manifestation of Tourette’s syndrome (twitching of the muscles of the face, involuntary winks, making faces, uncontrolled foul language);
  • The manifestation of Huntington's chorea (a severe and dangerous violation of movements up to complete loss of coordination, irreversible gradual distortions of speech and thinking, progressive death of the brain; in the future - complete erasure of the personality and uncontrollability of motor functions; the disease is incurable - only partial relief of suffering in the patient is possible; in most cases, the disease ends in the death of the patient);
  • The manifestation of psychosomatic disorders (which are not completely explained by the transferred somatic - not mental illnesses, but also not completely explained by current mental illnesses);
  • Manifestation of behavioral disorders in children and elderly patients;
  • Manifestation of stuttering;
  • The manifestation of persistent vomiting and persistent hiccups that are not amenable to other types of treatment.
  • For a variety of medicines, Haloperidol Decanoate is a supportive treatment for schizophrenia.

Haloperidol - side effects

What side effects does Haloperidol have? The instruction says this with utmost clarity.

Effect on the nervous system and sensory organs:

  • The phenomena of akathisia (restlessness);
  • Phenomena of dystonic extrapyramidal disorders (with spasm of the facial, cervical and spinal muscles, tics, twitches, weakness of the arms and legs);
  • Phenomena of Parkinson's extrapyramidal disorders (with difficulty during conversation and swallowing, with a “mask-like face” - the folds of muscles and facial skin are smoothed, facial expression does not correspond to feelings, with shuffling gait, hand and fingers with tremor (tremble);
  • The phenomena of a headache, often reaching intolerable;
  • The phenomena of insomnia;
  • The phenomena of drowsiness (even an alternation of drowsiness and insomnia is possible);
  • The phenomena of anxiety, anxiety, agitation, agitation (emotion);
  • Phenomena of euphoria (causeless state of unhealthy and quite prolonged joy - while the patient does not feel happy);
  • The phenomena of depression (causeless states of depression, often - an aversion to life and a desire to die);
  • The phenomena of lethargy (the state of "imaginary death" - all body functions mimic death, after an indefinite time all life functions return);
  • Epilepsy (a disease of convulsive seizures with loss of consciousness);
  • The phenomena of confused consciousness;
  • Cases of exacerbation (worsening, exacerbation) of psychosis;
  • Cases of hallucinations;
  • The phenomenon of tardive dyskinesia (see "Necessary Precautions");
  • Cases of visual acuity, cataracts (clouding of the lens in the eye), retinopathy (vascular disease of the retina).

Effect on the cardiovascular system, on blood formation processes:

  • The phenomenon of tachycardia (heart palpitations);
  • Cases of arterial hypertension / hypotension (high or low blood pressure);
  • Cases of ventricular arrhythmia (violation of the rhythm of heartbeats);
  • The picture of changes on the ECG (poor electrocardiogram of the heart);
  • Cases of sudden death of cardiovascular origin;
  • Cases of transient leukopenia and leukocytosis (a decrease or increase in the number of white blood cells indicates a weakening of the protective properties of the body, it is dangerous for the occurrence of blood cancer);
  • The phenomenon of erythropenia (a decrease in the number of red blood cells, indicates an insufficient amount of oxygen in the blood, dangerous for the occurrence of blood cancer);
  • Cases of anemia (lack of hemoglobin in the blood, also indicates a deficiency of oxygen in the body, dangerous by the presence of inflammatory processes);
  • The phenomenon of agranulocytosis (a decrease in the number of granulocytes - granular blood cells responsible for protecting the body from infections, dangerously severe inflammatory processes, the ultimate danger is the occurrence of blood cancer).

Effects on the respiratory system:

  • The phenomenon of laryngospasm (difficulty swallowing and speech);
  • The phenomenon of bronchospasm (difficulty breathing - as in asthma).

Action on the gastrointestinal tract

  • Cases of anorexia (rejection of any food through vomiting, dangerous exhaustion and even death from hunger);
  • Cases of constipation and diarrhea;
  • The phenomena of hypersalivation (unhealthy non-stop course of saliva);
  • Cases of irreversible nausea and vomiting;
  • Cases of impaired liver function;
  • Phenomenon of obstructive jaundice (mechanical blockage of the bile ducts).

Genitourinary Effects

  • Mammary glands - the phenomenon of engorgement (coarsening);
  • Cases of atypical secretion (unusual discharge) of milk;
  • The phenomenon of mastalgia (pain in the mammary gland);
  • The phenomenon of gynecomastia (an increase in the mammary glands in men);
  • The menstrual cycle is broken;
  • The phenomena of urinary retention;
  • Cases of impotence;
  • Cases of causeless increase in sexual desire;
  • Cases of priapism (prolonged erection for no apparent reason).

Effect on the skin

  • Cases of skin changes: maculopapular (rash consisting of spots and elevations of the skin) and acne-like (rash consisting of acne-acne);
  • Phenomenon of photosensitization (severe inflammation of the skin under the influence of light);
  • Cases of alopecia (hair loss).

Other side effects

  • Phenomenon of malignant antipsychotic syndrome (temperature rises above 40 degrees, heavy sweat separates, pressure drops, urine spontaneously leaves, muscles “stiffen”, faints, a semblance of coma appears. Causes of the condition have not been studied, treatment has not been developed. Death is likely);
  • Cases of hyperprolactinemia (an excess of the hormone prolactin is the cause of infertility and early cessation of menstruation);
  • The phenomena of hyperglycemia (high blood sugar) and hypoglycemia (low sugar);
  • Cases of hyponatremia (low sodium in the blood, dangerous brain edema).

Patients who, despite the presence of contraindications, were prescribed Haloperidol, their relatives should discuss the situation with the attending physician and require a replacement appointment, if possible.

Precautions for Haloperidol Treatment

The following dangerous trends have been identified in the treatment processes:

  • Elderly patients in whom psychosis is associated with dementia (senile memory loss) are at risk. They have an increase in mortality. The cause most often is problems from the field of cardiovascular diseases - the phenomena of heart failure, sudden death, pneumonia. Atypical antipsychotics, which in some cases are safer than Haloperidol, in this case give the same risk picture as TA.
  • Cases of tardive dyskinesia after prolonged use or discontinuation of the drug (tongue, face, mouth and jaw move involuntarily rhythmically - for example, the tongue protrudes, the cheeks puff out, the lips are puckered, there are phenomena of uncontrolled chewing movements, involuntary movements of the limbs and trunk). In a number of patients, tardive dyskinesia is irreversible. It is necessary to cancel the drug.
  • Cases of extrapyramidal disorders (see "Side effects")
  • Cases of cardiac abnormalities, including those involving sudden cardiac death.

The list of side effects and risks when using Haloperidol reveals the main problem associated with the use of the drug. Haloperidol is extremely dangerous. Doctors who use it in widespread practice (mainly in psychiatry) have a difficult choice. On the one hand, until recently it was not possible to treat the above diseases without Haloperidol. On the other hand, its use requires extreme caution and the doctor’s readiness at any time to begin additional treatment, already against the undesirable symptoms and syndromes that Haloperidol itself gives. The instruction reports: with a dangerous development of side effects, the drug must be discontinued. But in the vast majority of cases this is not possible, since cancellation will lead to exacerbations of the underlying disease.

AA is a partial solution to the problem, in particular, Seroquel (Quetiapine), for whom extrapyramidal disorders and dyskinesia were not noticed, and the therapeutic effect slightly exceeds the capabilities of Haloperidol. However, it is too early to say that AA is definitely better than TA - further clinical trials and practical observation are necessary.

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