Haloperidol Maximum Dose — MRCPsych Paper B MCQ
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Correct answer: E — 20 mg/day
The correct answer is E: 20 mg/day. The UK SmPC gives an oral dose range of 2–10 mg/day for schizophrenia and schizoaffective disorder, with 20 mg/day as the licensed maximum. Doses above 10 mg/day have not shown superior efficacy for most patients and are associated with more extrapyramidal adverse effects; QTc risk also increases with dose and plasma concentration. The indication matters: 10 mg/day is the maximum for delirium, while 15 mg/day is the maximum for bipolar mania. A maximum of 5 mg/day applies to several other indications and is the stated maximum in older patients before exceptional individual benefit–risk reassessment. Thirty milligrams was a historical maximum and is not the current licensed ceiling.
Reference: Electronic Medicines Compendium, HALDOL 2 mg/ml oral solution, Summary of Product Characteristics, section 4.2 Posology and method of administration, last updated 6 November 2023. https://www.medicines.org.uk/emc/product/15252/smpc