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Industry: Email Alert RSS FeedNon-psychotic uses for anti-psychotics
Journal of Drugs in Dermatology, March-April, 2004 by Aparche Yang, John Y. Koo
Table 1. Anti-psychotics: classes and FDA-approved indications
With the exception of five anti-psychotics (bolded). the official
FDA-approved indication for anti-psychotics is schizophrenia.
ANTI-PSYCHOTICS FDA-approved Indication(s) (3,4,6,7)
ADULTS CHILDREN
TYPICAL
HIGH-POTENCY
Fluphenazine Resistant Not approved
(Prolixin, Permitil, Schizophrenics
Modecate, Moditen)
Haloperidol Schizophrenia Psychotic disorders
(Haldol) ages: 3-12
Perphenazine 1. Schizophrenia Not approved in
(Trilafon) 2. Nausea and children < 12
emesis years old
Pimozide Resistant Tourette's > 12
(Orap) motor and years old
phonic ties in
patients with
Tourette's
Syndrome
Thiothixene Schizophrenia 1. Adolescents:
(Navane) adult dosing
2. Not approved
in children
< 12 years old
Trifluoperazine 1. Schizophrenia Psychotic disorders
(Stelazine) 2. Non-psychotic 6-12 years old
generalized
anxiety
disorders
MID-POTENCY
Loxapine Schizophrenia Not approved in
(Loxitane) children
Molindone Schizophrenia Adolescents:
(Moban) adult dosing
LOW-POTENCY
Chlorpromazine 1. Schizophrenia 1. Severe
(Thorazine) 2. Nausea, behavioral problems
emesis 2. Psychotic
3. Restlessness, disorders 6 months-
apprehension 12 years
prior to
surgery
4. Acute
intermittent
porphyria
5. Adjunct
treatment of
tetanus
6. Manic
depressive-like
illnesses
7. Intractable
hiccups
Mesoridazine Refractory Not approved
(Serentil) Schizophrenia
Thioridazine Refractory Behavioral disorders
(Mellaril) Schizophrenia 2-12 years
ATYPICAL
Clozapine Refractory Not approved
(Clozaril) schizophrenia
Risperidone Schizophrenia Not approved
(Risperdal)
Olanzapine 1. Schizophrenia Not approved
(Zyprexa, Zyprexa 2. Bipolar
Zydis) mania (only
atypical
approved)
Quetiapine Schizophrenia Not approved
(Seroquel)
Ziprasidone Schizophrenia Not approved
(Geodon)
ANTI-PSYCHOTICS Off-label, Non-Psychotic Indications
TYPICAL
HIGH-POTENCY 1. Cognitive disorder
associated with agitation (16)
2. Autism (8)
3. Impulse control (8)
4. Huntington's chorea (8)
5. Ballismus (8)
Fluphenazine 1. Conduct disorder (8)
(Prolixin. Permitil, 2. Huntington's chorea (8)
Modecate, Moditen)
Haloperidol 1. Non-psychotic, combative
(Haldol) behavior in adults (6)
2. Borderline personality
disorder (8)
3. Conduct disorder (8)
4. Huntington's chorea (8)
Perphenazine
(Trilafon)
Pimozide 1. Delusions of parasitosis (1)
(Orap) 2. Huntington's chorea (8)
Thiothixene Borderline personality
(Navane) disorder (8)
Trifluoperazine
(Stelazine)
MID-POTENCY
Loxapine
(Loxitane)
Molindone
(Moban)
LOW-POTENCY Mental Retardation with
severe agitation and
combativeness (8)
Chlorpromazine
(Thorazine)
Mesoridazine
(Serentil)
Thioridazine Nausea and emesis (8)
(Mellaril)
ATYPICAL
Clozapine Nausea and emesis (8)
(Clozaril)
Risperidone Unusually aggressive, non-
(Risperdal) psvchotic children (7)
Olanzapine
(Zyprexa, Zyprexa
Zydis)
Quetiapine
(Seroquel)
Ziprasidone
(Geodon)
Table 2. Off-label indications for antipsychotics
Non-psychotic Indication(s) Comprehensive Textbook of New Oxford Text
Psychiatry of Psychiatry
Kaplan and Sadock 1995 Gelder, Lopex-
Ibor and
Andreasen 2000
PSYCHIATRIC
MOOD DISORDERS +
(Manic excitement) All anti-psychotics
BORDERLINE PERSONALITY + +
D/O Low-dose: thiothixene,
haloperidol
COGNITIVE D/O ASSOCIATED + +
AGITATION Low dose, high potency
(Alzheimer's dementia,
Wernicke's and
Korsakoff's syndromes)
MENTAL RETARDATION +
(Severe agitation,
combativeness)
AUTISM + +
(severe withdrawal, High potency
hyperactivity, aggressive
and stereotyped behaviors)
ATTENTION-DEFICIT/ + +
HYPERACTIVITY DISORDER If stimulants not
effective
CONDUCT DISORDERS +
fluphenazine, haloperidol
IMPULSE CONTROL +
(w/propensity for violence Controversial, last
& agitation) resort Low dose, high
potency
SELF-INJURIOUS BEHAVIOR +
NON-PSYCHIATRIC
ANESTHESIA & ANALGESIA + increase the effects of
analgesics, hypnotics and
anesthetics; droperidol
b/c short 1/2 life
TIC DISORDERS + high-potency +
(Tourette's, treatment-
resistant OCD, intractable
hiccups)
Trichotillomania +
HUNTINGTON'S DISEASE +
(early--chorea; later-- High potency
psychological symptoms Fluphenazine,
including: irritability, Haloperidol, pimozide
paranoia, hallucinations,
violent tendencies, bizarre
behaviors)
BALLISMUS +
(hemiballism, confusion, Low dose, high potency
disorientation, dementia)
ESSENTIAL TREMOR +
WATER INTOXICATION +
SYNDROME
In Schizophrenic Patients
NAUSEA, EMESIS + +
All anti-psychotics,
especially chlorpromazine
prochlorperazine,
thioridazine, clozapine
PORPHYRIAS +
PURITIS + +
Trimeprazine (Temaril)
GERD (Gastro-Esophageal +
Reflux Disease), DELAYED Metoclopramide (Reglan)
GASTRIC EMPTYING
+ = Described in reference book.
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