First generation (typical) antipsychotics (Formulary)

Important: Formulation and dosage details

Formulation:

Tablets 25mg, 50mg, 100mg

Dosage:

Schizophrenia and other psychoses, mania, short-term adjunctive management of severe anxiety, psychomotor agitation, excitement, and violent or dangerously impulsive behaviour initially 25mg 3 times daily (or 75mg at night), adjusted according to response, to usual maintenance dose of 75 to 300mg daily (but up to 1 gram daily may be required in psychoses). Older or debilitated patients, third to half adult dose.

Important: Formulation and dosage details

Formulation:

Oral solution 25mg/5mL

Dosage:

Schizophrenia and other psychoses, mania, short-term adjunctive management of severe anxiety, psychomotor agitation, excitement, and violent or dangerously impulsive behaviour initially 25mg 3 times daily (or 75mg at night), adjusted according to response, to usual maintenance dose of 75 to 300mg daily (but up to 1 gram daily may be required in psychoses). Older or debilitated patients, third to half adult dose.

Important: Formulation and dosage details

Formulation:

Tablets 500 micrograms, 1mg, 3mg

Dosage:

Psychosis, initially 3 to 9mg twice daily adjusted according to the response; maximum 18mg daily. Older or debilitated patients, initially quarter to half adult dose. The 500 micrograms and 1mg tablets are off-label for this indication.

Important: Formulation and dosage details

Formulation:

Tablets 1·5mg, 5mg, 10mg

Dosage:

Schizophrenia and other psychoses, mania, short-term adjunctive management of psychomotor agitation, excitement, and violent or dangerously impulsive behaviour, by mouth, initially 500 micrograms to 3mg 2 to 3 times daily or 3 to 5mg 2 to 3 times daily in severely affected or resistant patients; in resistant schizophrenia up to 30mg daily may be needed; adjusted according to response to lowest effective maintenance dose (as low as 5 to 10mg daily). Older or debilitated patients, initially half adult dose. 

Agitation and restlessness in older people, by mouth, initially 500 micrograms to 1·5mg once or twice daily.

Important: Formulation and dosage details

Formulation:

Oral liquid 2mg/mL

Dosage:

Schizophrenia and other psychoses, mania, short-term adjunctive management of psychomotor agitation, excitement, and violent or dangerously impulsive behaviour, by mouth, initially 500 micrograms to 3mg 2 to 3 times daily or 3 to 5mg 2 to 3 times daily in severely affected or resistant patients; in resistant schizophrenia up to 30mg daily may be needed; adjusted according to response to lowest effective maintenance dose (as low as 5 to 10mg daily). Older or debilitated patients, initially half adult dose. 

Agitation and restlessness in older people, by mouth, initially 500 micrograms to 1·5mg once or twice daily.

Important: Formulation and dosage details

Formulation:

Injection 5mg/mL

Dosage:

By intramuscular injection, initially 2 to 10mg then every 4 to 8 hours according to response to total maximum 18mg daily; severely disturbed patients may require initial dose of up to 18mg; older or debilitated patients, initially half adult dose.

Important: Formulation and dosage details

Formulation:

Tablets 25mg

Dosage:

Schizophrenia, initially 25 to 50mg daily in divided doses increased as necessary; bedpatients initially 100 to 200mg daily usually in 3 divided doses, increased if necessary to 1 gram daily.

Important: Formulation and dosage details

Formulation:

Tablets 200mg, 400mg

Dosage:

200 to 400mg twice daily; maximum 800mg daily in predominantly negative symptoms, and 2400mg daily in mainly positive symptoms. Older people, lower initial dose, increased gradually according to response.

Important: Formulation and dosage details

Formulation:

Tablets 1mg, 5mg

Dosage:

Schizophrenia and other psychoses, short-term adjunctive management of psychomotor agitation, excitement, and violent or dangerously impulsive behaviour, initially 5mg twice daily, increased by 5mg daily after 1 week, then at intervals of 3 days, according to the response. Older people, reduce initial dose by at least half.

Important: Formulation and dosage details

Formulation:

Oral solution 1mg/5mL

Dosage:

Schizophrenia and other psychoses, short-term adjunctive management of psychomotor agitation, excitement, and violent or dangerously impulsive behaviour, initially 5mg twice daily, increased by 5mg daily after 1 week, then at intervals of 3 days, according to the response. Older people, reduce initial dose by at least half.

Important: Formulation and dosage details

Formulation:

Tablets 2mg, 10mg, 25mg

Dosage:

Schizophrenia and other psychoses, particularly when associated with agitated, aggressive, or hostile behaviour, initially 20 to 30mg daily in divided doses, increasing to a maximum of 150mg daily if necessary; usual maintenance dose 20 to 50mg daily. Older or debilitated patients, initially quarter to half adult dose.

Important: Formulation and dosage details

Formulation:

Solution for injection (oily) (Clopixol Acuphase®) 50mg/mL

Dosage:

By deep intramuscular injection into the gluteal muscle or lateral thigh, 50 to 150mg (older people 50 to 100mg), if necessary repeated after 2 to 3 days (1 additional dose may be needed 1 to 2 days after the first injection); maximum cumulative dose 400mg per course and maximum 4 injections; maximum duration of treatment 2 weeks. Avoid use in neuroleptic-naïve patients.