<unk>  is used in the control of the symptoms of: * Acute psychosis, such as drug-induced psychosis caused by LSD, psilocybin, amphetamines, ketamine, and phencyclidine, and psychosis associated with high fever or metabolic disease. Some evidence, however, has found<unk>  to worsen psychosis due to psilocybin. * Adjunctive treatment of alcohol and opioid withdrawal * Agitation and confusion associated with cerebral sclerosis * Alcohol-induced psychosis *<unk> lucinations in alcohol withdrawal * Hyperactive delirium (to control the agitation component of delirium) * Hyperactivity, aggression * Otherwise uncontrollable, severe behavioral disorders in children and adolescents * Schizophrenia * Therapeutic trial in personality disorders, such as borderline personality disorder * Treatment of intractable hiccups * Treatment of neurological disorders, such as tic disorders such as Tourette syndrome, and chorea * Treatment of severe nausea and emesis in postoperative and palliative care, especially for palliating adverse effects of radiation therapy and chemotherapy in oncology. Also used as a first line antiemetic for acute Cannabis Hyperemesis Syndrome.<unk>  was considered indispensable for treating psychiatric emergency situations, although the newer atypical drugs have gained a greater role in a number of situations as outlined in a series of consensus reviews published between 2001 and 2005. In a 2013 comparison of 15 antipsychotics in schizophrenia,<unk>  demonstrated standard effectiveness. It was 13–16% more effective than ziprasidone, chlorpromazine, and asenapine, approximately as effective as quetiapine and aripiprazole, and 10% less effective than paliperidone. A 2013 systematic review compared<unk>  to placebo in schizophrenia: Summary<unk>  often causes troublesome adverse effects. If there is no other antipsychotic drug, using<unk>  to offset the consequences of untreated schizophrenia is justified. Where a choice of drug is available, however, an alternative antipsychotic with less likelihood of adverse effects such as parkinsonism, akathisia and acute dystonias may be more desirable. Outcome Findings in words Findings in numbers Quality of evidence General outcomes No marked global improvementFollow-up: >6–24 weeks<unk> , when compared with placebo, reduces the chance of experiencing 'no improvement'. Data are based on moderate quality evidence. RR 0.67 (0.58 to 0.78) Moderate Not discharged from hospitalFollow-up: > 6–24 weeks<unk>  may reduce the chance of staying in hospital, but, at present it is not possible to be confident about the difference between people receiving<unk>  and people taking placebo. Data supporting this finding are very limited. RR 0.85 (0.47 to 1.52) Very low RelapseFollow-up: 6–24 weeks<unk>  probably slightly reduces the risk of loss to follow up, but the difference between the two treatments is not quite clear. Data supporting this finding are based on moderate quality evidence. RR 0.54 (0.29 to 1) Moderate Adverse effects – movement disorders ParkinsonismFollow-up: 3 weeks to 3 months<unk>  substantially increases the risk of movement disorders. Data are based on moderate quality evidence. RR 5.48 (2.68 to 11.22) Moderate Missing outcomes Severe adverse events, such as death, and outcomes such as satisfaction with treatment were not measured/reported in the included studies. Pregnancy and lactation Data from animal experiments indicate<unk>  is not teratogenic, but is embryotoxic in high doses. In humans, no controlled studies exist. Reports in pregnant women revealed possible damage to the fetus, although most of the women were exposed to multiple drugs during pregnancy. In addition, reports indicate neonates exposed to antipsychotic drugs are at risk for extrapyramidal and/or withdrawal symptoms following delivery, such as agitation, hypertonia, hypotonia, tremor, somnolence, respiratory distress, and feeding disorder. Following accepted general principles,<unk>  should be given during pregnancy only if the benefit to the mother clearly outweighs the potential fetal risk.<unk>  is excreted in breast milk. A few studies have examined the impact of<unk>  exposure on breastfed infants and in most cases, there were no adverse effects on infant growth and development. Other considerations Skeletal formula of<unk>  decanoate. The decanoate group is highlighted in . During long-term treatment of chronic psychiatric disorders, the daily dose should be reduced to the lowest level needed for maintenance of remission. Sometimes, it may be indicated to terminate<unk>  treatment gradually. In addition, during long-term use, routine monitoring including measurement of BMI, blood pressure, fasting blood sugar, and lipids, is recommended due to the risk of side effects. Other forms of therapy (psychotherapy, occupational therapy/ergotherapy, or social rehabilitation) should be instituted properly. PET imaging studies have suggested low doses are preferable. Clinical response was associated with at least 65% occupancy of D2 receptors, while greater than 72% was likely to cause hyperprolactinaemia and over 78% associated with extrapyramidal side effects. Doses of<unk>  greater than 5 mg increased the risk of side effects without improving efficacy. Patients responded with doses under even 2 mg in first-episode psychosis. For maintenance treatment of schizophrenia, an international consensus conference recommended a reduction dosage by about 20% every 6 months until a minimal maintenance dose is established. * Depot forms are also available; these are injected deeply intramuscularly at regular intervals. The depot forms are not suitable for initial treatment, but are suitable for patients who have demonstrated inconsistency with oral dosages. The decanoate ester of<unk> <unk>  decanoate, trade names<unk> dol decanoate,<unk> omonth, Neoperidole) has a much longer duration of action, so is often used in people known to be noncompliant with oral medication. A dose is given by intramuscular injection once every two to four weeks. The IUPAC name of<unk>  decanoate is 4-(4-chlorophenyl)-1-4-(4-fluorophenyl)-4-oxobutylpiperidin-4-yl decanoate. Topical formulations of<unk>  should not be used as treatment for nausea because research does not indicate this therapy is more effective than alternatives.
Haloperidol
Chlorpromazine
Domperidone
Sertindole
Iprindole
Desmethylclozapine
Thioridazine
Pirlindole