Haloperidol: instruction cautions

The subject of research in this article is the drug "Haloperidol", the instruction to which is taken as the basis of the material.

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

Substance belongs to the group of neuroleptics orantipsychotics. So it was called until the neuroleptics (antipsychotics) of a new generation appeared in pharmacology and pharmaceuticals of the 1990s. After that, Haloperidol was called the typical neuroleptic (TN) or the typical antipsychotic (TA). New generation drugs (for example, Seroquel, Olanzapine, etc.) are called atypical antipsychotics (AH) 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 he possesses sometimes lead to additional diseases that require separate treatment.

Some AA (Seroquel) of these side effects has not yet been detected.

Haloperidol, the instructions for whichconsidered in this material has a truly huge range of actions. It is enough to list the diseases that are treated with its use, so that the essential importance that it has in medical practice become apparent.

Haloperidol is used in the following cases.:

• Psychomotor excitement of variousof origin: mania (overexcitement with the commission of dangerous acts), cases of oligophrenia (mental retardation), psychopathy (diseases of cognition and behavior), schizophrenia (the most severe of all known mental diseases), chronic alcoholism
• Delusional disorders (inability to distinguish the real world from an imaginary reality);
• Hallucinatory disorders (absolute faith in delusional auditory or visual phenomena of reality, which actually does not exist);
• The manifestation of Tourette syndrome (twitching of the muscles of the face, involuntary winking, making grimaces, uncontrollable profanity);
• The manifestation of Huntington's chorea (severe and dangerousviolation of movements up to complete loss of coordination, irreversible gradual distortions of speech and thinking, progressive brain death; in perspective, a complete erasure of the personality and uncontrollability of motor functions; the disease is incurable - only partial relief of suffering is possible for the patient; in most cases, the disease ends in death of the patient);
• The manifestation of psychosomatic disorders (which are not fully explained by postponed somatic - not mental illnesses, but also not fully explained by current mental illnesses);
• The manifestation of behavioral disorders in patients of child and elderly;
• Manifestation of stuttering;
• The manifestation of stable vomiting and stable hiccups that are not amenable to other types of treatment.
• For a variety of medicines "Haloperidol Decanoate" - supportive treatment for the manifestations of schizophrenia.

Haloperidol - side effects

What side effects does haloperidol have? The instruction speaks of this with utmost clarity.

Effect on the nervous system and sense organs:

• Phenomena of akathisia (restlessness);
• Phenomena of dystonic extrapyramidal disorders (with spasm of facial, cervical and spinal muscles, ticking movements, twitching, weakness of arms and legs);
• Parkinsonian extrapyramidal phenomenadisorders (with difficulty during conversation and swallowing, with a “mask-like face” - the folds of the muscles and skin are smoothed, the facial expression does not match the senses, with a shuffling gait, the hand and fingers - with tremor (tremble);
• Phenomena of headache, often reaching unbearable;
• Insomnia;
• The phenomena of drowsiness (perhaps even the alternation of drowsiness and insomnia);
• The phenomena of anxiety, anxiety, arousal, agitation (agitation);
• The phenomena of euphoria (the gratuitous state of unhealthy and rather long joy - while the patient does not feel happy);
• The phenomena of depression (unreasonable states of depression, often - aversion to life and the desire to die);
• The phenomena of lethargy (the state of “imaginary death” - all functions of the body imitate death, after an indefinite time all vital functions return);
• Epilepsy (a disease of convulsive seizures with loss of consciousness);
• Phenomena of confused consciousness;
• Cases of exacerbation (deterioration, exacerbation) of psychosis;
• Cases of hallucinations;
• The phenomenon of tardive dyskinesia (see “Necessary precaution”);
• Cases of visual acuity, cataract phenomena (clouding of the lens in the eye), retinopathy phenomena (vascular disease of the retina).

Effect on the cardiovascular system, on blood formation processes:

• The phenomenon of tachycardia (rapid heartbeat);
• Cases of arterial hypertension / hypotension (high or low blood pressure);
• Cases of ventricular arrhythmias (heart rhythm disturbance);
• Picture of changes on the ECG (bad cardiac electrocardiogram);
• Cases of sudden death of cardiovascular origin;
• Cases of transient leukopenia and leukocytosis (decrease or increase in the number of white blood cells, indicates a weakening of the protective properties of the organism, is dangerous for the occurrence of blood cancer);
• The phenomenon of erythropenia (reduction in the number of red blood cells, indicates an insufficient amount of oxygen in the blood, dangerously the occurrence of blood cancer);
• Cases of anemia (lack of hemoglobin, also indicates a lack of oxygen in the body, dangerously the presence of inflammatory processes);
• Явление агранулоцитоза (уменьшение числа granulocytes - granular blood cells that are responsible for protecting the body against infections, dangerously severe inflammatory processes, the ultimate danger is the occurrence of blood cancer).

Effect 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, dangerously exhaustion, and even death from starvation);
• Cases of constipation and diarrhea;
• Phenomena of hypersalivation (unhealthy non-stop flow of saliva);
• Cases of irreversible nausea and vomiting;
• Cases of abnormal liver function;
• Obstructive jaundice (mechanical obstruction of the bile ducts).

Action on the urogenital system

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

Action 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);
• Photosensitivity phenomena (severe inflammation of the skin when exposed to light);
• Cases of alopecia (hair loss).

Other side effects

• The phenomenon of neuroleptic malignantsyndrome (temperature rises above 40 degrees, abundant sweat separates, pressure drops, urine involuntarily drains, muscles become numb, consciousness looses, a coma appears. The causes of the condition have not been studied, no treatment has been developed. Death is likely);
• Cases of hyperprolactinemia (an excess of the hormone prolactin - 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 swelling).

Patients who, despite the presence of contraindications, have been prescribed Haloperidol, their relatives should discuss the situation with the attending physician and demand that the appointment be replaced, if possible.

Necessary precaution when treating Haloperidol

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

• Elderly patients whose psychosis is associated withdementia (senile memory loss) are at risk. They noted an increase in mortality. The cause most often are 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 prolongedreception or withdrawal of the drug (involuntarily rhythmically move the tongue, face, mouth and jaw - for example, the tongue bulges, cheeks puff up, lips shrink, there are phenomena of uncontrolled masticatory movements, involuntary movements of the limbs and trunk). In a number of patients, tardive dyskinesia is irreversible. The abolition of the drug is necessary.
• Cases of extrapyramidal disorders (see. "Side effects")
• Cardiac abnormalities, including those involving sudden cardiac death.

Список побочных действий и рисков при using Haloperidol reveals the main problem associated with the use of the drug. Haloperidol is extremely dangerous. Doctors who use it in broad practice (mainly in psychiatry) have a difficult choice. On the one hand, it was not recently 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 start additional treatment, already against undesirable symptoms and syndromes, which Haloperidol itself gives. The instruction says: in case of dangerous side effects, the drug should be withdrawn. But in the vast majority of cases this is impossible, since cancellation will lead to exacerbations of the underlying disease.

Partial solution of the problem is given by AA - in particular,Seroquel (Quetiapine), behind which extrapyramidal disorders and dyskinesia are not seen, and the therapeutic effect somewhat exceeds the capabilities of Haloperidol. However, it is still too early to say that AA is definitely better than TA - it is necessary to continue clinical studies and practical observation.