Category:
Description:
Indications:
-
Psychoses,
Gilles de la Tourette syndrome, severe behavioral problems
-
Hyperactive
children (short term)
-
Prolonged
parenteral neuroleptic therapy for chronic schizophrenia (decanoate)
Contraindications:
Precautions:
-
Pregnancy
category C; has been used for hyperemesis gravidarum, chorea
gravidarum, and manic depressive illness during pregnancy; excreted in
breast milk; effect on nursing infant unknown, but may be of concern
-
Elderly,
severe cardiac disorders, seizure disorder
-
Hepatic
dysfunction, child < 3 years, alcohol withdrawal
-
Abrupt
withdrawal, glaucoma
Adverse
Reactions (Side Effects):
-
CNS:
agitation, anxiety, catatonic-like behavioral states, confusion,
depression, drowsiness, EPS (pseudoparkinsonism, akathisia, dystonia,
tardive dyskinesia), euphoria, exacerbation of psychotic symptoms
including hallucinations, headache, lethargy, neuroleptic malignant
syndrome, restlessness, seizures, vertigo
-
CV:
ECG changes, hypertension, hypotension, tachycardia
-
EENT:
blurred vision, cataracts, dry eyes, glaucoma, retinopathy
-
GI:
anorexia, constipation, diarrhea, dry mouth, dyspepsia,
hypersalivation, nausea, vomiting
-
GU:
priapism, urinary retention
-
HEME:
agranulocytosis, anemia, leukocytosis, minimal decreases in red blood
cell counts, transient leukopenia
-
METAB:
breast engorgement, gynecomastia, hyperglycemia, hyperprolactinemia,
impotence, increased libido, lactation, mastalgia, menstrual
irregularities
-
RESP:
bronchospasm, increased depth of respiration, laryngospasm
-
SKIN:
diaphoresis, loss of hair, isolated cases of photosensitivity,
maculopapular and acneiform skin reactions
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Dosage:
Administered
orally and intramuscularly
-
Adult:
-
Psychosis/Tourette’s
syndrome: PO 0.5-5mg 2-3 times daily initially depending on
severity of condition, dose is increased to desired dose, max
100mg daily; IM 2-5mg every 1-8 hours
-
Chronic
schizophrenia: IM 10-15 times the individual patient’s
stabilized PO dose every 4 weeks (decanoate)
-
Child
3-12 years:
-
Psychosis:
PO/IM 0.05-0.15 mg/kg/day in 2-3 divided doses
-
Tourette’s
syndrome: PO 0.05-0.075 mg/kg/day in 2-3 divided doses
-
Hyperactivity:
PO 0.05-0.075 mg/kg/day in 2-3 divided doses
Special
considerations:
Do
not mix liquid formulation with coffee or tea
Use
calibrated dropper
Take
with food or milk
Arise
slowly from reclining position
Do
not discontinue abruptly
Use
a sunscreen during sun exposure to prevent burns
Take
special precautions to stay cool in hot weather
Observe
closely for signs of tardive dyskinesia
|
Source:
Operational Medicine 2001, Health
Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau
of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington,
D.C., 20372-5300
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