Haldol & Tardive Dyskinesia

The first drug used in the United States for the treatment of schizophrenia was called chloropromazine. This medication was first marketed in the 1950s under the brand name Thorazine by Smith, Kline & French (currently GlaxoSmithKline). The chemical from which thr drug was derived was actually called promethazine, a substance that medical researchers in Europe had been studying as an alternative to morphine and other "narcotic" types of anesthesia. Although unsuitable for this purpose, doctors at a Paris hospital in the early 1950s discovered that the drug appeared to have a positive effect on mental patients in terms of emotional behavior and cognitive skills.

Chloropromazine was considered a "low-potency" drug. Eventually, two other classes of "high-potency" antipsychotic drugs were developed known as haloperidol and fluphenazine.

These three drugs make up what psychopharmacologists call "typical," "conventional" or "first-generation" neuroleptics (antipsychotic medications). These were the first such drugs to be developed for the treatment of mental illness, and although it has been proven that such drugs can cause symptoms of tardive dyskinesia in 30 percent of patients, these drugs are still considered the "first line" of treatment among psychiatric professionals.

Haloperidol and the United States

Few people in the U.S. have ever heard of Paul Janssen, founder of the mid-size Belgian drug company Janssen Pharmaceutica (now owned by Johnson & Johnson). Shortly after his death in 2003 at the age of 77 however, he was voted by the people of Belgium to have been one of that nation's greatest citizens. In the field of psychopharmacology, Janssen's major contribution was the discovery of haloperidol, a neuroleptic medication that was initially rejected in the U.S. because of its side effects.

Haloperidol was approved for use in the U.S. by the Food and Drug Administration in April 1967 and initially marketed under the brand name Haldol by McNeil Laboratories (also now owned by Johnson & Johnson). Other brand-names include Aloperidin, Bioperidolo, Brotopon, Dozic, Duraperidol, Einalon S, Eukystol, Halosten, Keselan, Linton, Peluces, Serenace, Serenase, and Sigaperidol. Among medical professionals, it is periodically referred to as "Vitamin H."

Mechanism, Dosage and Indications

Haloperidol is a powerful dopamine antagonist, meaning that it is highly effective at blocking dopamine receptors (dopamine is the neurotransmitter that facilitates communication between the brain and specific cells in the body), specifically those along the neural pathways that control voluntary muscle movement. In addition to preventing delusional behavior and even psychotic hallucinations, haloperidol has a sedative effect on those suffering from psychomotor agitation (unintentional, purposeless physical activity that increases with patient anxiety levels and is associated with bipolar disorder). This drug is usually administered via injection on a monthly basis.

In addition to schizophrenia, haloperidol is used to control mania in those with bipolar disorder, aggressive behavior, Tourette syndrome and other movement disorders. Most frighteningly, haloperidol is often used on adolescents, children and even adults who display "uncontrollable" behaviors.

Other Uses and Side Effects

Haloperidol is also used in the treatment of chronic pain in conjunction with other analgesics and as a medication for addicts suffering withdrawal symptoms from alcohol and/or opiates. Patients who suffer from drug-related psychoses (from LSD, psilocybin or amphetamines) may be treated with haloperidol. In oncology, haloperidol is administered to patients experiencing nausea as the result of radiation treatments or chemotherapy.

In addition to akathisia (a disorder movement associated with tardive dyskinesia) and extreme anxiety, haloperidol can cause unregulated blood pressure (either dangerously high or abnormally low), drymouth, constipation, excessive sweating, urinary problems, and in extreme cases, epileptic seizures and even coma. A study conducted in New York during the late 1990s suggest that women treated with haloperidol may run an elevated risk of developing breast cancer, but the results were not conclusive.

Haloperidol has been found in the milk of lactating women and children who are breastfed by these women are known to show symptoms of tardive dyskinesia and related disorders. It is highly recommended that pregnant and/or nursing women avoid taking this medication.