Last Updated on September 19, 2022 by
Alternative to Meds Editorial Team
Medically Reviewed by Dr John Motl MD
There may be some severe withdrawal symptoms that arise when coming off Haldol, despite claims or omissions that may seem to downplay such reactions.1,2,5
PLEASE NOTE: Unless medically indicated, never stop an antipsychotic drug abruptly.
Nausea, vomiting 3,15,16,17,18Haldol and other antipsychotic medications are heavily relied on in times of crisis, not focusing on future plans for Haldol withdrawal. But after the crisis passes, a patient may desire less risky treatment that doesn’t involve continuous drugging and over-sedating.
A momentary period of psychosis or mania does not have to mandate that a person’s whole life has to be on drugs. And do harsh antipsychotics cause their own add-on set of problems? You bet they do. Alternative to Meds Center can help.
Haldol (generic haloperidol) is an injectable antipsychotic medication. Haldol is one of the earlier drugs in this class, referred to as a FGA or “first-generation” antipsychotic medication.
Its uses include treating schizophrenia and also controlling disorders of motor movement or vocal tics as in Tourette’s syndrome.
Haldol comes in intramuscular injectable versions, some to be administered at approximately 4-week intervals, and other versions designed to be taken at intervals ranging from every hour to every 8-12 hours daily.1
Perhaps surprisingly, the FDA reports that most patients coming off short-term use of Haldol do not exhibit problems during withdrawal.1
Since studies done prior to the approval of Haldol were short (a number of weeks) there is no possible statement the FDA could make on long-term or high-dose users attempting Haldol withdrawal, since apparently it was not studied prior to approval. Researchers and clinicians who have studied Haldol withdrawal have observed the suffering of patients recommend gradual tapering to avoid the severe and debilitating withdrawals summarized above.
PLEASE NOTE: Haldol is NOT FDA approved for elderly patients with dementia-related psychosis, and is contraindicated in patients with Parkinson’s disease. Infants should not be nursed where the mother is taking Haldol, and extreme caution is advised during pregnancy since maternal use in humans and animals featured limb malformations and other birth defects as well as fatality.1,4
Tardive dyskinesia and cardiovascular adverse events are two notable concerns linked to Haldol, as stated by the FDA and independent research. Between 13% and 24% of patients treated with antipsychotic medications develop tardive dyskinesia.7,9 Elderly patients with dementia-related psychosis should not be treated with Haldol due to the increased risk of cardiac failure and death.1,4,7,8,9 See more on this topic below, where you can find additional information concerning withdrawal symptoms and other important safety topics relating to Haldol.
Haldol should not be combined with other medications or alcohol. Due to the synergistic effect of combining multiple CNS depressants, there is an augmented risk of death from respiratory failure or other potentially fatal risks and severe side effects.6
The FDA has given approval for Haldol to treat a variety of conditions.
*Research shows that although antipsychotic medications are often used to sedate patients with schizophrenia, mania, rage, or other psychiatric symptoms, they introduce the risk of developing tardive dyskinesia, an often irreversible drug-induced condition that may occur even after short-term use.1,7,8,9
Haldol has not developed a known street presence as a drug of abuse. Haldol is the brand or trade name for the generic drug haloperidol. Another version of the drug named Haldol Decanoate or haloperidol decanoate is a longer-acting form of Haldol, administered intramuscularly. In reference to its use for sedating violent patients, it is sometimes referred to as the Velvet Hammer for its profound and immediate sedative properties.3
Haldol (haloperidol) is a 1st-generation antipsychotic medication. First-generation antipsychotics such as Haldol are considered to have more severe side effects than the second-generation (later) antipsychotic medications.21
This is not a complete list but does show the extensive range of potential side effects that can affect virtually every part of the human body. Coupled with a lowered awareness of self and one’s environment, this suggests a person on Haldol needs careful monitoring by an alert and interested medically trained caregiver and should avoid driving or operating heavy machinery.
Before a person begins a regimen that includes antipsychotic medication, it is recommended that a thorough study and adequate research as well as consulting with a trusted physician is done to answer some of the most frequent questions that you may have concerning this class of drug. The following information may help in such research.
Haldol (haloperidol) or Haldol Decanoate is a long-acting antipsychotic medication. The extended-release version of this drug is prepared in sesame oil, to provide slow and sustained release over a 4-week period. The half-life of the drug is approximately 3 weeks. Plasma levels are seen to peak at about 6 days and then gradually begin to fall. After the third to fourth dose, the plasma levels remain steady. These are approximations that can vary due to age, weight, general health, genetic and other factors that can affect metabolization.1 Relatively new research on genetic testing has shown that certain genetic variances (polymorphisms) in individuals can affect the rate of metabolization and we look to more future research that can be used to help eliminate some adverse reactions associated with medications, especially relevant during withdrawal.27 Based on the downregulation of synaptic receptors, the time it takes to recalibrate back to premedicated states may be quite difficult to calculate or exactly predict.
It is just as difficult to answer the question, “How long will these adverse reactions last?” However, we find that safe withdrawal techniques combined with neurotransmitter precursors can considerably speed up this process.
Injected Haldol is not uncommon in certain instances, such as a violent arrest, or an extremely aggressive person requiring rapid sedation for public safety, as in a jail or other involuntary incarceration.3
Haldol is most often given when a person is in the middle of a crisis. Antipsychotic medications are able to control certain extreme episodes. Unfortunately, the person may be left on a high dose, because their condition has been, perhaps in error, considered permanent when in fact it was preceded by marijuana use, cocaine use, hyperglycemia, sleep deprivation, or a myriad of other causative events associated with psychosis.25,26
Many of our clients have expressed that it is easier to find a doctor to give Haldol than to find one who knows how to get a patient off the drug safely. The recommended course of action is to find a physician who understands and is familiar with the dynamics of this situation and can help you deal with it properly.
Please be aware for yourself or a loved one, that the practice of injection can have fatal consequences and heart monitoring should be done where the patient may be at risk of heart failure or other complications.1
Alternative to Meds Center welcomes persons who are looking for relief from symptoms that were not adequately resolved with drug-based treatments.
We know that an individual will have their own unique history and treatment needs that only a personalized treatment program can address.
Often, where it is medically feasible to do so, treatment plans may include assisting with Haldol withdrawal.
Haldol has the effect of blocking the “reward” neurotransmitter, dopamine. It is thought that by deflecting dopamine, a build-up in the synapses occurs, and as a result, manic behaviors may become lessened. The restriction of dopamine, as the chemical associated with reward, may have a dampening effect on one’s passion and ability to experience pleasure in life.22,23
This effect may not have provided a desired quality of life, and a person may desire other means to achieve improvements in health and mental health without prescription drugs. At Alternative to Meds Center, we include many therapeutic, drug-free means to help a person move toward these valuable improvements to their quality of life.
We also know it is necessary to exhaustively investigate the root causes of the symptoms that may have led to medication in the first place. With such investigations, lab testing and other methods can determine areas that can be greatly assisted through non-harmful, drug-free protocols. Examples are shown below.
Heavy metal and toxin removal, nutritional support through a clean diet & food-grade supplements, a warm social setting with peer support, counseling, equine therapy, neurochemistry rehabilitation, and many other protocols can significantly help a person achieve their goals toward achieving natural mental health, supported through tapering off prescription drugs or safely reducing drugs to the very smallest dosages that will allow for a satisfying quality of life.
As previously mentioned, it may be easier to find a doctor to prescribe Haldol than to find one who will help get you off the drug. Alternative to Meds Center specializes in recovery after drug therapy and has helped many thousands of clients who were stuck in a similar undesirable predicament.
This is not to suggest that it is going to be easy, but with careful, dedicated staff to assist, natural mental health is the goal, without relying heavily on drugs to dampen unwanted symptoms.
Through holistic methods, we can obtain a high rate of return in aiming to improve overall health and wellness and recovering from antipsychotic medications that did not adequately resolve these types of issues. Please ask us for more information on our Haldol withdrawal programs and treatments at Alternative to Meds Center which we are happy to discuss in detail with you or a loved one.
1. FDA Drug Label Information [Internet] 2005 [cited 2020 Aug 1]
2. Pendleton J article reviewer, “Haldol (Haloperidol) Typical and Atypical Antipsychotic Drugs” GoodTherapy [INTERNET] [cited 2020 Aug 1]
3. Keller J “Involuntary Chemical Sedation–The Right Medications” blog post, JailMedicine [INTERNET] 2013 Apr 13 [cited 2020 Aug 1]
4. Heerema E, “Research Haloperidol (Haldol) Poses Risks in Dementia.” 2020 Jan 30 [cited 2020 Nov 25]
5. Ifteni P, et al., ” Haloperidol and sudden cardiac death in dementia: autopsy findings in psychiatric inpatients.” Wiley Onlin Library 2015 Mar 19 [cited 2020 Nov 25]
6. Tanaka E. Toxicological interactions involving psychiatric drugs and alcohol: an update. J Clin Pharm Ther. 2003 Apr;28(2):81-95. doi: 10.1046/j.1365-2710.2003.00459.x. PMID: 12713604. [cited 2021 May 26]
7. Beasley CM, Dellva MA, Tamura RN, Morgenstern H, Glazer WM, Ferguson K, Tollefson GD. Randomised double-blind comparison of the incidence of tardive dyskinesia in patients with schizophrenia during long-term treatment with olanzapine or haloperidol. Br J Psychiatry. 1999 Jan;174:23-30. doi: 10.1192/bjp.174.1.23. PMID: 10211147. [cited 2021 May 26]
8. Cornett EM, Novitch M, Kaye AD, Kata V, Kaye AM. Medication-Induced Tardive Dyskinesia: A Review and Update. Ochsner J. 2017 Summer;17(2):162-174. PMID: 28638290; PMCID: PMC5472076. [cited 2021 May 26]
9. Seigneurie AS, Sauvanaud F, Limosin F. Dyskinésies tardives induites par les antipsychotiques : données actuelles sur leur prévention et prise en charge [Prevention and treatment of tardive dyskinesia caused by antipsychotic drugs]. Encephale. 2016 Jun;42(3):248-54. French. doi: 10.1016/j.encep.2015.12.021. Epub 2016 Feb 26. PMID: 26922134. [cited 2021 May 26]
10. Said Q, Gutterman EM, Kim MS, Firth SD, Whitehead R, Brixner D. Somnolence effects of antipsychotic medications and the risk of unintentional injury. Pharmacoepidemiol Drug Saf. 2008 Apr;17(4):354-64. doi: 10.1002/pds.1559. PMID: 18314925. [cited 2021 May 26]
11. Sanders RD, Gillig PM. Gait and its assessment in psychiatry. Psychiatry (Edgmont). 2010;7(7):38-43. [cited 2021 May 26]
12. Sinha P, Vandana VP, Lewis NV, Jayaram M, Enderby P. Predictors of Effect of Atypical Antipsychotics on Speech. Indian J Psychol Med. 2015;37(4):429-433. doi:10.4103/0253-7176.168586 [cited 2021 May 26]
13. Coughlin CG, Blackwell KA, Bartley C, Hay M, Yonkers KA, Bloch MH. Obstetric and neonatal outcomes after antipsychotic medication exposure in pregnancy. Obstet Gynecol. 2015;125(5):1224-1235. doi:10.1097/AOG.0000000000000759 [cited 2021 May 26]
14. Einarson A, Boskovic R. Use and safety of antipsychotic drugs during pregnancy. J Psychiatr Pract. 2009 May;15(3):183-92. doi: 10.1097/01.pra.0000351878.45260.94. PMID: 19461391. [cited 2021 May 26]
15. Moncrieff J. Does antipsychotic withdrawal provoke psychosis? Review of the literature on rapid onset psychosis (supersensitivity psychosis) and withdrawal-related relapse. Acta Psychiatr Scand. 2006 Jul;114(1):3-13. doi: 10.1111/j.1600-0447.2006.00787.x. PMID: 16774655. [cited 2021 May 26]
16. Keks N, Schwartz D, Hope J. Stopping and switching antipsychotic drugs. Aust Prescr. 2019;42(5):152-157. doi:10.18773/austprescr.2019.052 [cited 2021 May 26]
17. Bronson ME. Withdrawal from chronic haloperidol substitutes for the pentylenetetrazol discriminative stimulus. Life Sci. 1993;52(16):PL129-33. doi: 10.1016/0024-3205(93)90177-5. PMID: 8464331. [cited 2021 May 26]
18. Brandt et al., “Antipsychotic Withdrawal Symptoms.” Systematic Review Article, Frontiers in Psychiatry [29 Sept 2020] [online] [cited 2021 May 26]
19. Dilsaver SC, Alessi NE. Antipsychotic withdrawal symptoms: phenomenology and pathophysiology. Acta Psychiatr Scand. 1988 Mar;77(3):241-6. doi: 10.1111/j.1600-0447.1988.tb05116.x. PMID: 2899377. [cited 2021 May 26]
20. Stroup TS, Gray N. Management of common adverse effects of antipsychotic medications. World Psychiatry. 2018;17(3):341-356. doi:10.1002/wps.20567 [cited 2021 May 26]
21. Berman BD. Neuroleptic malignant syndrome: a review for neurohospitalists. Neurohospitalist. 2011;1(1):41-47. doi:10.1177/1941875210386491 [cited 2021 May 26]
22. Guzman F, “First vs Second-Generation Antipsychotics.” Open Access article, psychopharmacology Institute [online] June 27 2019 [cited 2021 May 26]
23. NIMH authors, “What are the possible side effects of antipsychotics?,” published in the US National Library of Medicine [cited 2021 May 26].
24. Saeedi H, Remington G, Christensen BK. Impact of haloperidol, a dopamine D2 antagonist, on cognition and mood. Schizophr Res. 2006 Jul;85(1-3):222-31. doi: 10.1016/j.schres.2006.03.033. Epub 2006 May 6. PMID: 16679001. [cited 2021 May 26]
25. Sahoo S, Mehra A, Grover S. Acute Hyperglycemia Associated with Psychotic Symptoms in a Patient with Type 1 Diabetes Mellitus: A Case Report. Innov Clin Neurosci. 2016;13(11-12):25-27. Published 2016 Dec 1. [cited 2021 May 26]
26. Shah D, Chand P, Bandawar M, Benegal V, Murthy P. Cannabis induced psychosis and subsequent psychiatric disorders. Asian J Psychiatr. 2017 Dec;30:180-184. doi: 10.1016/j.ajp.2017.10.003. Epub 2017 Oct 16. PMID: 29096386. [cited 2021 May 26]
27. Hockings JK, Pasternak AL, Erwin AL, Mason NT, Eng C, Hicks JK. Pharmacogenomics: An evolving clinical tool for precision medicine. Cleve Clin J Med. 2020 Feb;87(2):91-99. doi: 10.3949/ccjm.87a.19073. PMID: 32015062. [cited 2021 May 27]
Originally Published Sep 13, 2018 by Diane Ridaeus
Dr. Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona. He holds a Bachelor of Science degree with a major in biology and minors in chemistry and philosophy. He graduated from Creighton University School of Medicine with a Doctor of Medicine. Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.
Diane is an avid supporter and researcher of natural mental health strategies. Diane received her medical writing and science communication certification through Stanford University and has published over 3 million words on the topics of holistic health, addiction, recovery, and alternative medicine. She has proudly worked with the Alternative to Meds Center since its inception and is grateful for the opportunity to help the founding members develop this world-class center that has helped so many thousands regain natural mental health.
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