Dr. Ashok Kumar
Geriatrics
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Patient's Query
Hi doctor,
My son is diagnosed with bipolar type two disorder. He has been on Haldol 5 mg. Doctor prescribed a change to Loxapine. While starting on Loxapine doctor advised him to continue Haldol 2.5 mg for a week. But the patient is going through significant akathisia when on both, which is causing him unable to sleep. Can we give just Loxapine instead of both? He is also taking Cogentin 1 mg. In the past, he used to take Ability 10 mg. Kindly give your opinion.
Hello,
Welcome to icliniq.com.
As per the available description, it seems that Loxapine is the cause for akathisia, provided there was no akathisia with the use of Haldol (Haloperidol Decanoate) alone. Since the dose of Haldol is decreased to 2.5 mg from the previous 5 mg, the Haldol is unlikely a contributor toward akathisia.
However, to reconfirm, it is ideal to stop Haldol completely and hope for appropriate action from Loxapine. This can be done provided he is completely stable from a psychiatric point of view.
The only risk with the sudden withdrawal of Haldol is a relapse of his psychiatric illness. To conclude, Haldol can be stopped altogether if he is stable from a psychiatric point of view, keeping in mind the risk described above.
I hope this was helpful.
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Geriatrics
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