Acute or chronic psychosis, in the event of intolerance or treatment failurewith other antipsychotics (preferably use haloperidol for this indication)
Forms and strengths
25 mg and 100 mg tablets
Dosage
Adult: 25 to 50 mg once daily in the evening for one week. Increase gradually to 50 mg in the morning and 100 mg in the evening;if insufficient, administer 100 mg 3 times daily.
Reduce the dose by half in older patients.
Use the lowest effective dose, especially in the event of prolonged treatment.
Duration
Acute psychosis: at least 3 months
Chronic psychosis: at least one year
Discontinue treatment gradually (over 4 weeks). If signs of relapse occur, increase the dose then decrease it more gradually.
Contra-indications, adverse effects, precautions
Do not administer to patients with cardiac disorders (heart failure, recent myocardial infarction, conduction disorders, bradycardia, etc.), dementia (e.g. Alzheimer's disease), closed-angle glaucoma, prostate disorders, Parkinson's disease and history of neuroleptic malignantsyndrome.
Administer with caution and carefully monitor use in older patients and patients with hypokalaemia, hypotension, renal or hepatic impairment, history of seizures.
hyperglycaemia, photosensitivity, impaired thermoregulation; agranulocytosis, neuroleptic malignant syndrome (unexplained hyperthermia with neuromuscular disorders), rare but requiring immediate treatment discontinuation.
In case of extrapyramidal symptoms,try reducing the dose of chlorpromazine or, if the extrapyramidal symptomsare severe, add biperiden or trihexyphenidyl.
Avoid or monitor combination with:
central nervous system depressants (opioid analgesics, sedatives, H1 antihistamines, etc.); drugs with anticholinergic effects (amitriptyline, atropine, promethazine, etc.), antidiabetics, lithium;
antihypertensive drugs (risk of hypotension); drugs that prolong the QT interval (amiodarone, chloroquine, erythromycin, fluconazole, mefloquine, pentamidine, quinine, etc.).
Avoid alcohol during treatment(increased risk of adverse effects).
Pregnancy: re-evaluate whether the treatmentis still necessary; if it is continued, use the lowest effective dose. Observe the neonate the first few days (risk of agitation, tremors, hypertonia/hypotonia, respiratory difficulties, sleeping disorders, etc.) if the mother was under treatment in the 3rd trimester. If treatment starts during pregnancy, preferably use haloperidol.
Breast-feeding: if absolutely necessary,use the lowest effective dose.