Basically using the newer antipsychotics.
Olanzapine (Zyprexa)
Comes as: PO tablets, Rapid disintegrating tablets, IM
Starting: 2.5 mg PO QD Daily: 5-10 mg/day
Risperidone (Risperdal)
PO tabs and syrup, Rapidly disintegrating tablet (for those who can ’t swallow)
Starting: 0.25 mg PO BID
Daily: 0.25-1.5 mg/day
Quetiapine (Seroquel)
PO tabs, Extended-release tabs (50 mg +)
Starting: 25 mg PO BID
Daily: 25-400 mg/day
Aripiprazole (Abilify)
PO Tabs, Oral solution (I mg./ml)
Starting: 5 mg
Daily: 5-15 mg/day
Ziprasidone(Geodon)
PO caps, IM (20 mg/ml)
Starting: 10 mg twice daily
Daily: 20-160/day
Note: Little PO and IM experience in older persons; not recommended as the first line in geriatric patients
Acute Psychosis and/or Unable to Use Oral Formulation
Olanzapine (Zyprexa )
Dose: 2.5 mg IM
5-10 daily is geriatric dose
Haloperidol (Haldol)
Administer IM, NOT IV (IV torsade)
Starting dose: 0.125 mg IM Q6 •
When acute psychosis resolved, if substantive doses used, need to taper, if only a few doses were needed, can stop
Treatment of choice in benzodiazepine and alcohol withdrawal: Lorazepam (Ativan) 0.25 or 0.5 mg q 6 prn as the initial dose