What happens after an oral ingestion of haloperidol decanoate? - A case report / O que ocorre após a ingestão oral de decanoato de haloperidol? - Um caso clínico

ABSTRACT Haloperidol decanoate is a first generation antipsychotic drug used to treat patients with schizophrenic disorder who require prolonged parenteral antipsychotic therapy. Cases of oral haloperidol decanoate are rare, and only one has been reported in foreign literature. In this report, we present a case of an oral ingestion of haloperidol decanoate of a male with schizophrenic disorder who presented to the emergency department following an oral ingestion of 1 ampoule of haloperidol decanoate 100 mg. At presentation he was hemodynamically stable. He was maintained on vigilance for 12 hours after what was discharged to the outpatient unit for psychiatric follow-up. The bioavailability and pharmacokinetic of oral intake of haloperidol decanoate are unknown. Although there is a report of treatment with oral activated charcoal in this case there was no need of intervention.

RESUMO O decanoato de haloperidol é um antipsicótico de primeira geração utilizado no tratamento de pacientes com esquizofrenia que requeiram tratamento antipsicótico parentérico prolongado. Casos de intoxicação oral com decanoato de haloperidol são raros, e apenas um foi reportado na literatura estrangeira. Neste artigo apresentamos o caso de ingestão oral de decanoato de haloperidol realizada por um homem com esquizofrenia que se apresentou no serviço de urgência após a ingestão oral de uma ampola de 100 mg de decanoato de haloperidol. À apresentação, evidenciava estabilidade hemodinâmica. Foi mantido em vigilância durante 12 horas, após as quais teve alta e foi orientado a realizar consulta externa com psiquiatria para seguimento. A biodisponibilidade e a farmacocinética da ingestão oral de decanoato de haloperidol sãp desconhecidas. Apesar de estar descrito o tratamento oral com carvão ativado, neste caso não houve necessidade de intervenção.

Neurolepsia prolongada com decanoato de haloperidol no tratamento de dermatite psicogênica em um cão doméstico (Canis familiaris, 1758) / Long-term Neurolepsy with Haloperidol Decanoate in the Treatment of Psychogenic Dermatitis in a Domestic Dog (Canis Familiaris, 1758) / Neurolepsia de largo plazo con decanoato de haloperidol en el tratamiento de dermatitis psicogénica en un perro (canis familiaris 1758)

Relata-se o tratamento de um caso de dermatite psicogênica em um cão Rottweiler macho, com idade de 13 meses, pesando 42 kg. O paciente apresentava graves lesões dermatológicas devidas a auto-mutilação por lambedura, em ambas as regiões metatarsianas, e a anamnese indicava que o distúrbio psíquico tivesse origem no estresse provocado por uma mudança ambiental. Prescreveu-se tratamento com um neuroléptico de ação prolongada, o decanoato de haloperidol, com dose calculada por meio de extrapolação alométrica interespecífica, usando-se como modelo a dose total humana de 100 mg/70 kg. A dose total calculada para o cão de 42 kg foi de 70 mg, sendo administrada semanalmente, durante seis semanas. Já na segunda semana a recuperação era satisfatória, sendo que a cura completa foi obtida no 28º dia de tratamento. Mantido em observação por um período de seis meses, o paciente não apresentou quaisquer sinais de recidiva. Os resultados indicam que a droga apresenta excelentes perspectivas para o tratamento desta dermatopatia canina, e que o método de extrapolação alométrica interespecífica é plenamente eficiente no estabelecimento de protocolos posológicos individualizados.

ABSTRACT: This paper reports the results of the treatment of a 13 month-old male Rottweiler dog, weighing 42 kg, affected by psychogenic dermatitis. The patient presented serious cutaneous lesions due to self-licking, affecting both metatarsal areas. Anamnesis indicated that the psychic disturbance was caused by stress provoked by an environmental change. It was prescribed haloperidol decanoate, a long-acting neuroleptic, with dose calculated by interspecifi c allometric scaling, using as model the human total dose of 100 mg/70 kg. The total dose calculated for the 42 kg dog was 70 mg, and it was administered weekly for six weeks. Clinical recovery was already satisfactory in the second week, and complete cure was obtained in the 28th day of treatment. The patient was monitored by a six months period and did not present any relapsing signs. The results indicate that the drug presents excellent perspectives for the treatment of this canine skin disease, and that the method of interespecifi c allometric scaling is effi cient in the establishment of individualized therapeutic protocols.KEY WORDS: psychogenic dermatitis, neuroleptic, haloperidol decanoate, allometric scaling, dog

RESUMEN: Relata-se el tratamiento de un caso de dermatitis psicogénica en un perro Rottweiler macho, con edad de 13 meses y peso de 42 kg. El paciente presentaba graves lesiones dermatológicas debidas a auto-mutilación por lamedura, en ambas las regiones metatarsianas, y la anamnesia indicaba que la enfermedad tuviese origen en el estrés provocado por un cambio ambiental. Se prescribió tratamiento con un agente neuroléptico de acción prolongada, el decanoato de haloperidol, con dosis calculada por extrapolación alométrica interespecífi ca, se usando como modelo la dosis total humana de 100 mg/70 kg. La dosis total calculada para el perro de 42 kg fue de 70 mg, sendo administrada semanalmente, durante seis semanas. La recuperación clínica ya era satisfactoria en la segunda semana, y la cura completa se obtuvo en el vigésimo octavo día de tratamiento. El paciente fue supervisado por un periodo de seis meses y no presentó ninguna señal de retorno de la enfermedad. Los resultados indican que la droga presenta perspectivas excelentes para el tratamiento de esta enfermedad en perros, y que el método de extrapolación alométrica descascarar es en el establecimiento de protocolos terapéuticos individualizados.

Effects of Haloperidol Decanoate Treatment on the Rat Brain: Morphological and Neurochemical Study / 대한정신약물학회지

Using vacuous chewing movement(VCM) of rats as a possible animal model for tardive dyskinesia(TD), we tried to investigate the effects of haloperidol decanoate treatment on the rat brain: VCM(+) incidence, and morphological and neurochemical effect in the VCM(+) group. In our study, there were three treatment schedules of vehicle or haloperidol decanoate: 4, 7 or 9 total number of injections of vehicle or haloperidol decanoate were administered over 9, 18 or 24 weeks, respectively, with an injection given every 3 weeks. We rated VCM scores of rats at each injection time. Haloperidol groups were then further divided into VCM(-) rats and VCM(+) rats according to their VCM scores. Afterward, VCM(+) incidence was obtained in each haloperidol group. As time of neuroleptic treatment increased, the VCM scores and incidence of VCM(+) were found to be increased. All of the control, VCM(+) and VCM(-) rats were sacrificed to determine if treatments had morphological and neurochemical effects in the brain. Density of medium-sized neurons and levels of GABA in the striatum were reduced in the VCM(+) group 3 with total 9 injections given, compared to either VCM(-) group 3 or control group 3. These results suggest that hypofunction of GABAnergic neurons is associated with the development of VCM and possibly, TD.

Effects of Haloperidol Decanoate Treatment on the Rat Brain: Morphological and Neurochemical Study / 대한정신약물학회지

Using vacuous chewing movement(VCM) of rats as a possible animal model for tardive dyskinesia(TD), we tried to investigate the effects of haloperidol decanoate treatment on the rat brain: VCM(+) incidence, and morphological and neurochemical effect in the VCM(+) group. In our study, there were three treatment schedules of vehicle or haloperidol decanoate: 4, 7 or 9 total number of injections of vehicle or haloperidol decanoate were administered over 9, 18 or 24 weeks, respectively, with an injection given every 3 weeks. We rated VCM scores of rats at each injection time. Haloperidol groups were then further divided into VCM(-) rats and VCM(+) rats according to their VCM scores. Afterward, VCM(+) incidence was obtained in each haloperidol group. As time of neuroleptic treatment increased, the VCM scores and incidence of VCM(+) were found to be increased. All of the control, VCM(+) and VCM(-) rats were sacrificed to determine if treatments had morphological and neurochemical effects in the brain. Density of medium-sized neurons and levels of GABA in the striatum were reduced in the VCM(+) group 3 with total 9 injections given, compared to either VCM(-) group 3 or control group 3. These results suggest that hypofunction of GABAnergic neurons is associated with the development of VCM and possibly, TD.