II. Class
- Atypical Antipsychotic (Second Generation agent)
- Neuroleptic
III. Adverse Effects
- Insomnia
- Hypotension
- Weight gain
-
Extrapyramidal Side Effects
- Low risk when daily dose under 10 mg
- Peristent Tardive Dyskinesia
- Lower Incidence than with other Neuroleptics
- Exacerbates Parkinson's Disease movement
IV. Dosing
- Initial
- Adult: 1 mg PO bid
- Elderly: 0.25 mg qd to 0.5 mg PO bid
- Slow titration to average dosing
- Adult: 2 to 4 mg PO daily (or divided bid)
- Elderly with Dementia: 0.5 to 0.75 mg PO bid
- Maximum: 16 mg/day
V. Monitoring
- See Antipsychotics
- Consider EKG, Electrolyte and Magnesium monitoring due to QT Interval prolongation risk
VI. Drug Interactions
- Metabolized by Cytochrome P450 2D6
- Increase Antipsychotic levels (toxicity risk): Monitor for toxicity
- Decrease Antipsychotic levels (lower efficacy)
- Other effects
- Increased antihypertensive effect (may result in Hypotension)
- Raises Prolactin levels
- Avoid concurrent use of other medications prolonging QT Interval
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