Dosage Adult: PO Schizophrenia Initial: 2 mg/day, up to 4 mg/day on the 2nd
day if needed. May further adjust doses at wkly intervals. Maintenance:
4-6 mg/day. Max: 16 mg/day. Acute manic episodes of bipolar disorder Initial: 2-3 mg once daily. May increase slowly if needed. Max: 6 mg/day. IM Schizophrenia Give oral risperidone for a few days to assess tolerability before IM inj. For patients not stabilised on oral risperidone or patients stabilised on oral risperidone for 2 wk in doses 4 mg/day: 25 mg 2 wkly. For patients stabilised on oral risperidone for 2 wk in doses >4 mg/day: 37.5 mg 2 wkly. Continue oral risperidone for the 1st 3 wk after the 1st inj. Click to view risperidone Dosage by Indications Administration May be taken with or without food. Overdosage For action to be taken in the event of accidental overdose ... click to view risperidone Special Preexisting CV diseases; discontinue use if signs and symptoms of Precautions tardive dyskinesia occur; renal and hepatic impairment, elderly, epilepsy; parkinsonism; pregnancy. May cause drowsiness and orthostatic hypotension. Gradual withdrawal is recommended. Monitor blood glucose in diabetics and patients at risk of developing diabetes. Adverse Drug Agitation, anxiety, dizziness, headache, somnolence; orthostatic Reactions hypotension; constipation, dyspepsia, nausea, vomiting, abdominal pain, blurred vision, erectile dysfunction, priapism, rhinitis, rash and allergy, galactorrhoea, gynaecomastia, menstrual disorders, extrapyramidal symptoms (rarely). weight gain, oedema, tardive dyskinesia. Potentially Fatal: Neuroleptic malignant syndrome may occur rarely; seizures. May cause increased mortality in elderly with dementia-related psychosis. Drug Interactions May antagonise the effects of levodopa and dopamine agonists. May increase serum levels of clozapine when used together. Increased serum levels of carbamazepine when used concurrently. Carbamazepine may also decrease the serum levels of risperidone. Increased risk of neuroleptic malignant syndrome when used with indinavir and ritonavir. Potentially Fatal: Risperidone may enhance the hypotensive effect of certain antihypertensives. Click to view more risperidone Drug Interactions Dosage Adult: PO Prevention of drug-induced extrapyramidal symptoms Initial: 1 mg/day, increased gradually. Maintenance: 5-15 mg/day in 3-4 divided doses. Max: 15 mg/day. Idiopathic parkinsonism Initial: 1 mg/day in 3-4 divided doses, increased gradually up to 6-10 mg/day according to response. Advanced cases: 12-15 mg/day in 3-4 divided doses. Postencephalitic patients: Larger doses may be needed. Click to view trihexyphenidyl hydrochloride Dosage by Indications Administration Should be taken with food. (Best taken w/ meals. Take before meals if dry mouth occurs, after meals if drooling/nausea occurs. Take at the same time each day.) Overdosage For action to be taken in the event of accidental overdose ... click to view trihexyphenidyl hydrochloride Contraindications Patients with closed-angle glaucoma, chronic pulmonary disease, sick sinus syndrome, thyrotoxicosis, cardiac failure with tachycardia. Special Glaucoma, obstructive disease of GI or genitourinary tracts. In elderly Precautions males with possible prostatic hypertrophy. Liver and renal disorders. Pregnancy and lactation. Adverse Drug Dry mouth, blurring of vision, constipation, urinary retention, glaucoma, Reactions confusion, drowsiness, restlessness, hallucinations. Potentially Fatal: Arrhythmias, AV dissociation, multiple ventricular ectopics. Drug Interactions Delayed absorption of other oral drugs. Potentially Fatal: Additive anticholinergic activity with tricyclic antidepressants, antiparkinsonian drugs, antihistaminics, phenothiazine and quinidine. Click to view more trihexyphenidyl hydrochloride Drug Interactions Mechanism of For details of the mechanism of action, pharmacology and Action pharmacokinetics and toxicology ... click to view trihexyphenidyl hydrochloride MIMS Class Antiparkinsonian Drugs Dosage Adult: PO Intractable hiccup Initial: 25-50 mg 3-4 times/day for 2-3 days. Psychoses 25 mg 3 times/day. Maintenance: 25-100 mg 3 times/day, increased to 1 g/day if needed in psychotic patients. IM Psychoses 25-50 mg 6-8 hrly. Nausea and vomiting Initial: 25 mg via IM inj, followed by 25-50 mg 3-4 hrly until vomiting stops. Rectal Psychoses As supp: 100 mg 6-8 hrly . Click to view chlorpromazine Dosage by Indications Administration May be taken with or without food. (May be taken w/ meals to reduce GI discomfort.) Overdosage For action to be taken in the event of accidental overdose ... click to view chlorpromazine Contraindications Hypersensitivity; preexisting CNS depression, coma, bone-marrow supression; phaeochromocytoma; lactation. Special Parkinson's disease; CV disease; renal or hepatic impairment; Precautions cerebrovascular and respiratoty disease; jaundice; DM; hypothyroidism; paralytic ileus; prostatic hyperplasia or urinary retention; epilepsy or history of seizures; myasthenia gravis; pregnancy; elderly (especially with dementia), and debilitated patients. Avoid direct sunlight. Adverse Drug Tardive dyskinesia (on long-term therapy). Involuntary movements of Reactions extremities may also occur. Dry mouth, constipation, urinary retention, mydriasis, agitation, insomnia, depression and convulsions; postural hypotension, ECG changes. Allergic skin reaction, amenorrhoea, gynaecomastia, weight gain. Hyperglycaemia and raised serum cholesterol. Potentially Fatal: Agranulocytosis. Instantaneous deaths associated with ventricular tachyarrhythmias. Marked elevation of body temperature with heat stroke. Neuroleptic malignant syndrome, extrapyramidal dysfunction. Drug Interactions Potentiation of anticholinergic effects of antiparkinson agents and TCAs may lead to an anticholinergic crisis. Additive orthostatic hypotensive effect in combination with MAOIs. Reverses antihypertensive effect of guanethidine, methyldopa andclonidine. Potentially Fatal: Additive depressant effect with sedatives, hypnotics, antihistamines, general anaesthetics, opiates andalcohol. Click to view more chlorpromazine Drug Interactions Pregnancy Category (US FDA) Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus. Mechanism of For details of the mechanism of action, pharmacology and Action pharmacokinetics and toxicology ... click to view chlorpromazine MIMS Class Antiemetics / Antipsychotics ATC N05AA01 - chlorpromazine ; Belongs to the class of phenothiazine Classification antipsychotics with aliphatic side-chain. Dosage Adult: PO Psychoses 0.5-5 mg 2-3 times/day, up to 100 mg/day in severe cases. Maintenance: 3-10 mg/day. Severe tics; Tourette's syndrome Initial: 0.5-1.5 mg 3 times/day, up to 10 mg/day in Tourette's syndrome. Adjunct in severe anxiety or behavioral disturbances 0.5 mg twice daily. Restlessness and confusion 1-3 mg 8 hrly. Intractable hiccup 1.5 mg 3 times/day. IM Acute psychosis 2-10 mg hrly or 4-8 hrly until symptoms are controlled. Max: 18 mg/day. Nausea and vomiting0.5-2 mg/day. SC Restlessness and confusion 5- 15 mg over 24 hr. Click to view haloperidol Dosage by Indications Administration May be taken with or without food. (May be taken w/ meals to minimise GI irritation.) Overdosage For action to be taken in the event of accidental overdose ... click to view haloperidol Contraindications Severe toxic CNS depression; preexisting coma; Parkinson's disease; lactation. Special Parkinsonism; epilepsy, allergy, angle-closure glaucoma, benign prostatic Precautions hyperplasia; severe cardiac or hepatic disease; extremes in temp (hot and cold weather); presence of acute infections or leucopenia; hyperthyroidism; pregnancy, elderly, children. Patients receiving anticoagulants. Discontinue upon signs of neurological toxicity in patients taking haloperidol and lithium. Adverse Drug Tardive dyskinesia; extrapyramidal reactions. Anxiety, drowsiness, depression, Reactions anorexia, transient tachycardia, postural hypotension, leukopenia; anticholinergic side effects. Potentially Fatal: Neuroleptic malignant syndrome. Drug Interactions Carbamazepine and rifampicin reduce plasma concentrations. Symptoms of CNS depression may be enhanced by CNS depressants e.g. alcohol, hypnotics, general anaesthetics, anxiolytics and opioids. May reduce antihypertensive action ofguanethidine. May increase risk of arrhythmia when used with drugs that prolong QT interval or diuretics that can cause electrolyte imbalance. May increase plasma levels of haloperidol when used with clozapine or chlorpromazine. Potentially Fatal: Increases lithium blood levels and may predispose to neuroleptic malignant syndrome. Click to view more haloperidol Drug Interactions Pregnancy Category (US FDA) Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus. Mechanism of For details of the mechanism of action, pharmacology and pharmacokinetics Action and toxicology ... click to view haloperidol MIMS Class Antipsychotics / Antivertigo Drugs ATC Classification N05AD01 - haloperidol ; Belongs to the class of butyrophenone derivatives antipsychotics.