Haldol (Haloperidol) 0.5 mg / 1 mg / 2 mg / 5 mg / 10 mg / 20 mg Tablets: Prescription First-Generation Antipsychotic for Schizophrenia, Acute Psychosis, and Delirium Agitation

Information last reviewed: May 2026 — for educational purposes only.

What Is Haldol (Haloperidol)?

Haloperidol, branded as Haldol, is a first-generation (typical) antipsychotic of the butyrophenone class. It is a potent, selective dopamine D2 receptor antagonist — blocking dopaminergic signalling in the mesolimbic pathway to reduce positive psychotic symptoms (hallucinations, delusions, paranoia, disorganised speech). First approved in 1967, haloperidol remains one of the most potent and widely used antipsychotics globally, particularly in emergency and inpatient settings for its reliability, rapid onset IV/IM formulations, and low cost. Its high D2 affinity also creates a significant risk of extrapyramidal side effects (EPS) compared to atypical antipsychotics.

Prescription (Rx) Status

Haloperidol is prescription-only. Available as oral tablets, oral concentrate solution, and injectable formulations (short-acting IM/IV; long-acting decanoate depot). The FDA black-box warning applies for increased mortality in elderly dementia patients with psychosis. Haloperidol must be used carefully — QTc prolongation risk with IV administration requires cardiac monitoring.

Uses of Haloperidol

FDA-approved: schizophrenia, Tourette's syndrome, and acute agitation (IM). Widely used off-label: acute psychosis (emergency departments), delirium management in ICU settings, nausea/vomiting (at low doses), bipolar mania (acute). Long-acting Haldol Decanoate injection is used for maintenance therapy in non-adherent patients with schizophrenia.

Tablet Strengths

Haloperidol oral tablets: 0.5 mg, 1 mg, 2 mg, 5 mg, 10 mg, and 20 mg. Oral concentrate: 2 mg/mL. Typical dose range for schizophrenia: 1–15 mg/day in divided doses or once daily. Starting dose: 0.5–2 mg 2–3 times daily, titrating slowly. Elderly or de novo patients begin at the lowest available strength.

Price

Generic haloperidol tablets are very affordable. A 30-day supply of 2 mg tablets typically costs $10–$25. The injectable and depot formulations vary considerably in cost by setting.

Frequently Asked Questions

Q: What are extrapyramidal side effects (EPS)?
A: EPS are movement disorders caused by dopamine blockade in the nigrostriatal pathway, including: drug-induced parkinsonism (rigidity, tremor, shuffling gait), akathisia (restless inability to sit still), acute dystonia (muscle spasms), and tardive dyskinesia (late-onset involuntary facial/body movements) with long-term use.

Q: How is Haldol different from atypical antipsychotics?
A: Haloperidol selectively blocks D2 receptors, giving it high EPS risk but low metabolic side effects. Atypicals (risperidone, quetiapine, olanzapine) also block 5-HT2A receptors, reducing EPS but increasing weight gain and metabolic risks.

Q: Can haloperidol cause neuroleptic malignant syndrome?
A: Yes — NMS is a rare but life-threatening reaction to antipsychotics characterised by hyperthermia, muscle rigidity, altered consciousness, and autonomic instability. Discontinue immediately and seek emergency care if suspected.

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