Haloperidol Max — MRCPsych Paper B MCQ
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Correct answer: C — 20 mg/day
The correct answer is C: 20 mg/day. The UK SmPC gives an oral dose of 2–10 mg/day for adults with schizophrenia or schizoaffective disorder, with an absolute maximum of 20 mg/day. Doses above 10 mg/day have not shown superior efficacy for most patients, increase the risk of extrapyramidal adverse effects and should be considered only after an individual benefit–risk assessment. A maximum of 5 mg/day applies to older adults, not this 35-year-old patient. Although 10 mg/day is the upper end of the usual treatment range, it is not the absolute maximum. Thirty milligrams daily exceeds the licensed maximum, and haloperidol does not have an unrestricted dose ceiling.
Reference: Electronic Medicines Compendium, HALDOL 2 mg/ml oral solution, Summary of Product Characteristics, section 4.2 Posology and method of administration, updated 6 November 2023. https://www.medicines.org.uk/emc/product/15252/smpc