Antipsychotic Medication Options

Introduction to Alternative Antipsychotics

The American Academy of Family Physicians recommends risperidone (Risperdal) at an initial dosage of 0.25 mg per day at bedtime with a maximum of 2-3 mg per day, though extrapyramidal symptoms may occur at doses of 2 mg per day 1
The American Academy of Family Physicians suggests olanzapine (Zyprexa) is generally well tolerated, starting at 2.5 mg per day at bedtime with a maximum of 10 mg per day 1
The American Academy of Family Physicians notes quetiapine (Seroquel) is more sedating but can be effective, starting at 12.5 mg twice daily with a maximum of 200 mg twice daily 1

The American Academy of Pediatrics recommends monitoring for potential side effects, including QT prolongation, which is a concern with many antipsychotics, with haloperidol causing an average 7 ms prolongation 2
The American Academy of Pediatrics advises that when administering antipsychotics parenterally, intramuscular dosing is preferred over intravenous due to safety concerns 2
Extrapyramidal symptoms are common with typical antipsychotics like haloperidol but occur less frequently with atypical agents, according to the American Academy of Family Physicians 1, 3

For elderly patients with dementia-related psychosis, the American Academy of Family Physicians suggests that atypical antipsychotics should be preferred over typical agents like haloperidol due to reduced risk of extrapyramidal symptoms and tardive dyskinesia 1