Editing Haloperidol (section)

=== Other considerations ===
[[File:Haloperidol decanoate highlighting ester group.svg|class=skin-invert-image|thumb|right|[[Skeletal formula]] of [[haloperidol decanoate]]. The decanoate group is highlighted in {{color|red|red}}.]]

During long-term treatment of chronic psychiatric disorders, the daily dose should be reduced to the lowest level needed for maintenance of remission.  Sometimes, it may be indicated to terminate haloperidol treatment gradually.{{citation needed|date=April 2022}} In addition, during long-term use, routine monitoring including measurement of BMI, blood pressure, fasting blood sugar, and lipids, is recommended due to the risk of side effects.<ref name="APA schizophrenia guideline" />

Other forms of therapy (psychotherapy, occupational therapy/ergotherapy, or social rehabilitation) should be instituted properly.{{Citation needed|date=April 2013}}
PET imaging studies have suggested low doses are preferable. Clinical response was associated with at least 65% occupancy of D2 receptors, while greater than 72% was likely to cause hyperprolactinaemia and over 78% associated with extrapyramidal side effects. Doses of haloperidol greater than 5&nbsp;mg increased the risk of side effects without improving efficacy.<ref>{{cite journal | vauthors = Oosthuizen P, Emsley RA, Turner J, Keyter N | title = Determining the optimal dose of haloperidol in first-episode psychosis | journal = Journal of Psychopharmacology | volume = 15 | issue = 4 | pages = 251–255 | date = December 2001 | pmid = 11769818 | doi = 10.1177/026988110101500403 | s2cid = 40788955 }}</ref> Patients responded with doses under even 2&nbsp;mg in first-episode psychosis.<ref>{{cite journal | vauthors = Tauscher J, Kapur S | title = Choosing the right dose of antipsychotics in schizophrenia: lessons from neuroimaging studies | journal = CNS Drugs | volume = 15 | issue = 9 | pages = 671–678 | year = 2001 | pmid = 11580306 | doi = 10.2165/00023210-200115090-00001 | s2cid = 30091494 }}</ref> For maintenance treatment of schizophrenia, an international consensus conference recommended a reduction dosage by about 20% every 6 months until a minimal maintenance dose is established.<ref name="APA schizophrenia guideline">{{cite web | author = Work Group on Schizophrenia |title = Practice Guideline for the Treatment of Patients With Schizophrenia | edition = Second  |url = http://psychiatryonline.org/content.aspx?bookID=28&sectionID=1665359#45892 |archive-url = https://web.archive.org/web/20120327230029/http://psychiatryonline.org/content.aspx?bookid=28&sectionid=1665359#45892 |url-status = dead |archive-date = 27 March 2012 |access-date = 21 April 2014 }}</ref>
* Depot forms are also available; these are injected deeply intramuscularly at regular intervals. The depot forms are not suitable for initial treatment, but are suitable for patients who have demonstrated inconsistency with oral dosages.{{Citation needed|date=April 2013}}

The [[decanoate]] ester of haloperidol ([[haloperidol decanoate]], trade names Haldol decanoate, Halomonth, Neoperidole) has a much longer [[duration of action]], so is often used in people known to be noncompliant with oral medication. A dose is given by intramuscular injection once every two to four weeks.<ref>Goodman and Gilman's ''Pharmacological Basis of Therapeutics'', 10th edition (McGraw-Hill, 2001).{{page needed|date=September 2012}}</ref> The [[IUPAC name]] of haloperidol decanoate is [4-(4-chlorophenyl)-1-[4-(4-fluorophenyl)-4-oxobutyl]piperidin-4-yl] decanoate.

[[Topical medication|Topical formulations]] of haloperidol should not be used as treatment for nausea because research does not indicate this therapy is more effective than alternatives.<ref name="AAHPMfive">{{Cite journal |author1 = American Academy of Hospice and Palliative Medicine |author1-link = American Academy of Hospice and Palliative Medicine |title = Five Things Physicians and Patients Should Question |publisher = [[American Academy of Hospice and Palliative Medicine]] |journal = Choosing Wisely: An Initiative of the ABIM Foundation |url = http://www.choosingwisely.org/doctor-patient-lists/american-academy-of-hospice-palliative-medicine/ |access-date = 1 August 2013 |url-status = live |archive-url = https://web.archive.org/web/20130901101934/http://www.choosingwisely.org/doctor-patient-lists/american-academy-of-hospice-palliative-medicine/ |archive-date = 1 September 2013 }}, which cites
* {{cite journal | vauthors = Smith TJ, Ritter JK, Poklis JL, Fletcher D, Coyne PJ, Dodson P, Parker G | title = ABH gel is not absorbed from the skin of normal volunteers | journal = Journal of Pain and Symptom Management | volume = 43 | issue = 5 | pages = 961–966 | date = May 2012 | pmid = 22560361 | doi = 10.1016/j.jpainsymman.2011.05.017 | doi-access = free }}
* {{cite journal | vauthors = Weschules DJ | title = Tolerability of the compound ABHR in hospice patients | journal = Journal of Palliative Medicine | volume = 8 | issue = 6 | pages = 1135–1143 | date = December 2005 | pmid = 16351526 | doi = 10.1089/jpm.2005.8.1135 }}</ref>