Haldol vs. Thioridazine for Schizophrenia: Important Differences and Potential Risks.

Key takeaways

Haloperidol (Haldol) and thioridazine (Mellaril) are both typical antipsychotics used to treat schizophrenia, but they have some key differences. Haloperidol is available as an oral tablet, oral liquid, and injection, while thioridazine is taken orally multiple times a day. Haloperidol is often used as a first-choice treatment, whereas thioridazine is reserved for cases where other antipsychotics haven't worked or caused intolerable side effects. Both medications can cause dangerous heart rhythm changes (QTc prolongation). Both medications can cause serious side effects like neuroleptic malignant syndrome and should not be used in older adults with dementia-related psychosis.

haloperidol injection

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Thioridazine

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Summary for Haldol

Prescription only

Haloperidol injection is an antipsychotic medication that's used to treat schizophrenia. It's a long-acting injection that's given into the muscles monthly by a healthcare provider. It's also available as a shorter-acting injection that's typically given in a hospital setting to people who are experiencing agitation related to schizophrenia. The most common side effects of haloperidol injection are movement-related side effects, such as rigid muscles, tremors, and trouble speaking.

Indications for Haldol

Schizophrenia

Pros and Cons for Haldol

Pros

Typically given monthly
Low risk for weight gain, compared to some other antipsychotics
Available as a lower-cost, generic medication

Cons

Needs to be injected
Higher risk of movement-related side effects compared to atypical antipsychotics
Can't be used in children

Common Side Effects for Haldol

Stiff or rigid muscles, tremors, trouble speaking, and other parkinsonism symptoms (31%)

Warnings for Haldol

Higher risk of death in older people with dementia-related psychosis
Life-threatening abnormal heart rhythm (QT prolongation)
Difficulty controlling body movements
Neuroleptic malignant syndrome (NMS)
Higher risk of falls
Pneumonia
Low white blood cell counts
Harm to unborn babies

Summary for Thioridazine

Prescription only

Thioridazine, previously known under the brand name Mellaril, treats adults and children with schizophrenia. This first-generation antipsychotic, or also called typical antipsychotic, is typically used only when other antipsychotic medications haven't worked well. Thioridazine tablets are taken by mouth a few times throughout the day. The dosage depends on how well the medication is helping with your symptoms and whether you're having side effects like dry mouth, sleepiness, and nausea. Thioridazine can also cause a serious heart rhythm problem called QT prolongation, so it's not a first-choice option.

Indications for Thioridazine

Schizophrenia when other antipsychotic medications haven't worked well or have caused bothersome side effects

Pros and Cons for Thioridazine

Pros

Less risk for weight gain than with atypical antipsychotics
Less likely to have problems with muscle movements than other antipsychotic medications
Available in many different strengths

Cons

Must take many times a day
Not a first-choice option because it has many potential side effects
Can't take with certain medications, such as fluoxetine (Prozac) and propranolol (Inderal), because it raises the risk for dangerous changes in heart rhythm