My son stopped taking vrylar had a psychotic episode and now has been prescribed haldol- any one have any info or experience with it?
Haldol is an older ‘typical’ antipsychotic which is being revisited because it is one of the most potent antipsychotics which allows lower dosages to be used. Typicals are more likely to have anticholinergic (dry mouth, sedation and drooling) and Parkinson’s-like (rigidity and tremors) side-effects, but much less likely to cause high cholesterol and metabolic syndrome side-effects that atypical antipsychotics have to varying degrees.
Atypical antipsychotics have been argued to have an effect on negative symptoms, but my experience is their efficacy on these symptoms are minimal to non existent. One difference from atypical antipsychotics is you feel more obviously medicated when you take typicals. This can be both good and bad. While you may feel physically better and freer, less tense and constrained, you might be more tempted to cease medication thinking it doesn’t really ‘do anything’ which is obviously a bad thing. It’s also easier to gauge whether you have remembered to take your dose, because you can feel it. While I haven’t taken Hadol specifically, I’ve taken similar meds for decades. I believe Hadol is the only one commonly prescribed nowadays and is the only typical medication available as a long lasting injectable. The main drawback is a higher incidence of Tardive dyskinesia with long term use, but this is a risk of most antipsychotics.
Edit: I left Clozapine out of this as it is it is what I’ll call an ‘atypical atypical’. Reports are that it can noticeably help with negative symptoms, but has a rare serious side-effect that requires periodic blood testing. It’s treated as a drug of last resort in the US despite an anecdotal ‘miracle drug’ reputation among many caregivers.
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My son is having pretty good results with Haldol. Some of the second-generation drugs don’t seem to do much for him, so he tried an older one. I hope it works well for your son!
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Thank you both for your responses. I often am in uncharted territory scrambling to understand the medical decisions made. I am hoping that my son will agree to an injection- removing the daily choice/burden of taking meds. I had only heard of haldol s use in er’s to “put down” those in psychosis. Does 5mg twice a day sound like a heavy dose?
It’s on the higher side for a starter dose.
- Moderate disease, 0.5-2 mg q8-12hr initially
- Severe disease, 3-5 mg q8-12hr initially; not to exceed 30 mg/day
If that’s the only AP he’s taking, I don’t think it’s a heavy dose.