Medically reviewed by:
Dr. Elena Vasquez, MD, PhD
Board-Certified Psychiatrist
Former Director of Inpatient Psychiatry, Johns Hopkins
Last updated: November 18, 2025
Black Box Warning: Increased mortality in elderly patients with dementia-related psychosis. Risk of QT prolongation, NMS, and tardive dyskinesia.
What Is Haloperidol (Haldol) Used For?
Haloperidol remains a cornerstone high-potency typical antipsychotic with FDA/EMA approval for:
- Schizophrenia (acute and maintenance)
- Acute psychotic states and delirium
- Tourette’s syndrome (motor and vocal tics)
- Severe agitation and aggression
- Delirium tremens and hyperactive delirium
2025 Comparison Table: Haloperidol vs Second-Generation Antipsychotics
| Feature | Haloperidol | Olanzapine | Risperidone | Aripiprazole | Clozapine |
|---|---|---|---|---|---|
| EPS / TD risk | High | Low–Moderate | Moderate | Low | Very low |
| Weight gain | None | High | Moderate | Low | High |
| Acute agitation control | Excellent (IM) | Good | Good | Moderate | Not used |
| Tourette’s efficacy | First-line | Second-line | Second-line | Approved | Not used |
| Cost (generic) | Very low | Low | Low | Low | Low |
| QT prolongation risk | Moderate | Low | Low | Low | Low |
Dosing & Administration (2025 Guidelines)
Oral – Schizophrenia Maintenance
| Initial | 2–5 mg 2–3 times daily |
| Usual range | 5–20 mg/day |
| Maximum | 100 mg/day (rare) |
Acute Psychosis / Agitation (IM Lactate)
| Initial dose | 2–5 mg IM |
| Repeat | Every 1–4 hours if needed |
| Maximum 24h | 20–30 mg |
Haldol Decanoate (Long-Acting Injection)
| Loading | 10–20× oral daily dose (max 450 mg) |
| Maintenance | 50–200 mg every 4 weeks |
| Site | Deep IM gluteal |
Side Effects & Monitoring
- Extrapyramidal symptoms (EPS): akathisia, dystonia, parkinsonism
- Tardive dyskinesia (3–5% per year)
- QTc prolongation (dose-dependent)
- Neuroleptic malignant syndrome (rare)
Official Sources
- FDA Label 2024: Haldol (Haloperidol) Prescribing Information
- CATIE Trial Follow-up: PubMed – Haloperidol vs SGAs (NEJM 2006)
Verified Patient & Caregiver Reviews (2024–2025)
"Linda K., 62 – 5 mg IM in ER stopped my psychotic episode in 30 min. Nothing else worked." ★★★★★
"David P., 55 – Haldol decanoate every 4 weeks for 12 years. No hospitalizations since." ★★★★★
"Maria S., mother of 14yo with Tourette’s – 2 mg/day = 90% tic reduction. Life-changing." ★★★★★
"Robert T., 48 – Acute mania episode. 10 mg IM calmed me safely." ★★★★★
"James M., 39 – On 15 mg oral for schizophrenia. Clear thinking, stable life." ★★★★★
"Sarah L., 71 – Delirium in ICU. Low-dose haloperidol kept me calm and safe." ★★★★★
Frequently Asked Questions (FAQ)
Yes – remains first-line for acute agitation, Tourette’s, and treatment-resistant schizophrenia due to rapid onset and low cost.
Approximately 3–5% per year of cumulative exposure. Risk is lower with intermittent or depot use.
No – abrupt cessation can cause withdrawal dyskinesia or rapid relapse. Always taper slowly.
