Dosage strategies with long-acting injectable neuroleptics, including haloperidol decanoate

Concern about the dose of neuroleptic drugs has become widespread in recent years. This concern largely has been prompted by recognition of the apparent relationship between neuroleptic dose and potential adverse effects, such as tardive dyskinesia and extrapyramidal symptoms. Therefore, it is critical to establish dosing strategies for long-term therapy that emphasize a minimal effective dose. Such a dosing strategy for long-acting injectable neuroleptics, including haloperidol decanoate, is highlighted. A low initial dose of the long-acting drug is recommended, with gradual dosage adjustment over an extended period of time. General guidelines for using oral supplementation are also provided.