It’s very risky. Several studies have reported high rates of the induction of mania or hypomania and rapid-cycling in children with bipolar disorder who are exposed to antidepressant drugs of all classes. In addition, the child may experience a marked increase in irritability and aggression. Many parents on the BPParents listserv (an on-line community of parents who communicate with each other from all over the world via E-mail) reported that their children experienced psychosis and were hospitalized subsequent to their treatment with antidepressants. Some children did well for weeks or even for three months before a switch into mania and ultra-rapid mood shifts began.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Also does not lead to cardiorespiratory depression. Effective in calming patients with delirium. IV route is not FDA approved but supported by the Society of Critical Care Medicine guidelines [Crit Care Med 30: 119, 2002]. D-blocker, works within 10-20 minutes and lasts for several hours. Only causes hypotension in hypovolemic patients or those on beta-blockers. May be ideal for weaning mechanically ventilated patients [Crit Care Med 22: 433, 1994]. IV doses range from –2 to 5-10 to 10–20 mg for mild, moderate, and severe anxiety. Individual patients show significant variation in serum levels after a single dose, so if there is no response give a second, double-dose after 10 minutes. Do not give a third dose (switch agents). Extrapyramidal reactions are rare and are decreased in incidence when benzodiazepines are added [J Intensive Care Med 4: 201, 1989]. More feared adverse events include NMS and torsades – note that % of patients on Haldol will show QT prolongation [Am J Cardiol 81: 238, 1998], thus pre-existing QT interval is a contraindication. Haldol-associated QT prolongation may be exacerbated in the presence of class III antiarrhythmics, hypocalcemia and intracranial hypertension. Also, Haldol is a mild selective -antagonist. Its safety has been questioned in acute head injury, as animal studies suggest worsening of secondary brain injury by the central antidopaminergic effect – a recent animal study suggested that single or multiple low doses of risperidone and haloperidol may be innocuous to recovery after traumatic brain injury, but that chronic high-dose treatments are detrimental [Crit Care Med 35:919, 2007]. Lastly, Haldol may lower the seizure threshold (Andrews, citation needed).