Haldol decanoate initiation

Haloperidol is a typical butyrophenone type antipsychotic that exhibits high affinity dopamine D 2 receptor antagonism and slow receptor dissociation kinetics. [42] It has effects similar to the phenothiazines . [17] The drug binds preferentially to D 2 and α 1 receptors at low dose (ED 50 = and  mg/kg, respectively), and 5-HT 2 receptors at a higher dose (ED 50 =  mg/kg). Given that antagonism of D 2 receptors is more beneficial on the positive symptoms of schizophrenia and antagonism of 5-HT 2 receptors on the negative symptoms, this characteristic underlies haloperidol's greater effect on delusions, hallucinations and other manifestations of psychosis. [43] Haloperidol's negligible affinity for histamine H 1 receptors and muscarinic M 1 acetylcholine receptors yields an antipsychotic with a lower incidence of sedation, weight gain, and orthostatic hypotension though having higher rates of treatment emergent extrapyramidal symptoms .

Given these considerations, antipsychotic drugs should be prescribed in a manner that is most likely to minimize the occurrence of tardive dyskinesia. Chronic antipsychotic treatment should generally be reserved for patients who suffer from a chronic illness that 1) is known to respond to antipsychotic drugs, and 2) for whom alternative, equally effective, but potentially less harmful treatments are not available or appropriate. In patients who do require chronic treatment, the smallest dose and the shortest duration of treatment producing a satisfactory clinical response should be sought. The need for continued treatment should be reassessed periodically.

In a related issue, Risperdal sales practices resulted in a 2012 provisional settlement totaling $ billion. [17] The United States Department of Justice began investigating Risperdal sales practices in 2004, and in 2010 joined a whistleblowers suit alleging bribes paid to Omnicare , the largest company supplying pharmaceutical drugs to nursing homes. [18] [19] The allegations include that Johnson & Johnson and Janssen were warned by the . Food and Drug Administration (FDA) not to promote Risperdal as effective and safe for elderly patients when in fact it is associated with early death, but they did so; and that they in fact bribed Omnicare pharmacists tens of millions of dollars to promote the drug to care home physicians for this unapproved use. A settlement was provisionally agreed with Johnson & Johnson of around $ billion for this and related allegations, with Omnicare having already settled for around $100 million. [17] Former head of sales and president of Janssen, Alex Gorsky , who the Dept of Justice say “was actively involved” in the fraud, nevertheless become the new CEO of Johnson & Johnson in 2012. [20]

Haldol decanoate initiation

haldol decanoate initiation

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