Antipsychotic  ·  First-Generation Antipsychotic

Haloperidol

Also known as: Haldol (global), Serenace, Haloper, Halopidol, Peridol, Dozic, Fortunan

One of the most widely used antipsychotic medicines in Kenya, available from health centre level for the treatment of psychosis, schizophrenia, and severe agitation.

ATC CodeN05AD01
Kenya EML 2023Listed
Level of UseLevel 3 to 6
This is health education, not medical advice. Never start, stop, or change a medication without speaking to a qualified healthcare professional first.
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Prescription Only Medicine

Available on prescription. Often prescribed alongside biperiden to manage movement-related side effects.

Which conditions is Haloperidol used for?

What is Haloperidol?

Haloperidol is a first-generation antipsychotic medicine developed in the late 1950s and still widely used today. It is effective at reducing the symptoms of psychosis, such as hallucinations, delusions, and severely disorganised thinking, and at calming acute agitation.

It is listed at Level 3 in Kenya's Essential Medicines List 2023, making it available from health centre level upwards. This accessibility makes it a cornerstone of mental health treatment across Kenya.

Haloperidol is available in tablet form for daily oral use and as a long-acting injection given every few weeks, which is particularly helpful for people who find it difficult to take daily oral medicine consistently.

What does it do in the brain?

Haloperidol works primarily by blocking dopamine receptors in the brain. Dopamine, when overactive in certain brain pathways, is associated with psychotic symptoms like hearing voices or strongly held unusual beliefs. By reducing dopamine activity in these pathways, haloperidol helps reduce these experiences. The same action in other parts of the brain is responsible for the movement-related side effects this medicine can cause.

How is it available?

Tablet
1.5 mg, 5 mg, 10 mg
Taken by mouth
Widely available
Injection (short-acting)
5 mg/mL
Given by injection in hospital
Available at hospital level
Depot injection
Long-acting, every 4 weeks
Given by a nurse or doctor
Available at specialist centres

Where is it available in Africa and what is it called?

Names and availability vary by country. Always confirm with a local pharmacist or healthcare provider.
CountryCommon Brand Name(s)Notes
KenyaHaldol, Serenace, Haloper, genericOn KEML 2023 Level 3. Available from health centre level upwards.
South AfricaHaldol, Serenace, genericOn South Africa EML. Widely available including depot.
NigeriaHaldol, Serenace, genericWidely available across public and private facilities.
UgandaGeneric haloperidolAvailable at all levels of the public health system.
TanzaniaGeneric haloperidolAvailable at health centres and above.
EthiopiaGeneric haloperidolOn Ethiopia EML. Available at public facilities.
GhanaHaldol, genericAvailable at public facilities and private pharmacies.
RwandaGeneric haloperidolAvailable within the national health system.
ZambiaGeneric haloperidolAvailable at district hospitals and above.

What might you feel while taking it?

These are the most commonly reported effects. Not everyone experiences them, and many settle within the first few weeks.

  • Stiffness or slowness of movement, similar to Parkinson's disease symptoms
  • Restlessness and an uncomfortable urge to keep moving (akathisia)
  • Muscle spasms, particularly in the neck, face, or eyes, especially early in treatment
  • Sedation and drowsiness
  • Dizziness when standing up
  • Changes in menstrual cycle or breast changes in both men and women
Go to a doctor or emergency room straight away if you notice any of the following.
  • Involuntary repetitive movements of the face, lips, tongue, or limbs that develop after long-term use. Report these immediately.
  • Very high fever, extreme muscle stiffness, and confusion occurring at the same time. This is a medical emergency.
  • An irregular or unusually fast heartbeat

Important risks you should understand before taking this medicine

Read this section carefully. These are real risks associated with this medicine that every person taking it should be aware of.
  • Haloperidol causes movement side effects (extrapyramidal symptoms) more frequently than newer antipsychotics. These can include painful muscle spasms, shuffling gait, restlessness, and tremor. They are treatable but must be reported to your doctor.
  • With long-term use, a condition called tardive dyskinesia can develop, involving involuntary repetitive movements of the face, tongue, or limbs. This may be irreversible if not detected early. Regular monitoring is essential.
  • Haloperidol can cause a rare but life-threatening reaction called Neuroleptic Malignant Syndrome (NMS), with very high fever, extreme muscle rigidity, and confusion. This is a medical emergency requiring immediate hospital care.
  • Haloperidol can prolong the heart's electrical cycle (QT prolongation), which may cause dangerous heart rhythm disturbances. This risk increases at higher doses or when combined with other medicines affecting the heart.
  • Elderly patients with dementia who receive antipsychotics have a significantly increased risk of stroke and death. Use in this group requires careful specialist justification.

Important warnings before starting

Tell your doctor about all your medical conditions, allergies, and other medicines before starting Haloperidol.
  • You have been diagnosed with Parkinson's disease
  • You are heavily sedated from medicines or other substances
  • You have been told you have a tumour called a phaeochromocytoma

Situations that need extra attention

  • Biperiden is often co-prescribed to reduce movement side effects. Take it as directed.
  • Elderly people with dementia should only take antipsychotics under careful specialist review.
  • Tell your doctor about any heart rhythm problems before starting.
  • Do not drive or operate heavy machinery until you know how this medicine affects you.
Pregnancy
Speak to your doctor if you are pregnant or planning a pregnancy. The risks and benefits of continuing or changing treatment need careful consideration.
Breastfeeding
Haloperidol passes into breast milk. The decision to breastfeed while taking this medicine requires specialist guidance.

Medicines and substances that can interact with it

Always tell your doctor and pharmacist about every medicine, supplement, and herbal remedy you take, including those bought without a prescription.
  • Lithium: Used together in some cases, but high combined levels carry a risk of neurological effects.
  • Medicines that cause drowsiness including alcohol: Sedative effect is significantly amplified.
  • Medicines affecting heart rhythm: Combined effect on the heart's electrical cycle requires medical review.
  • Carbamazepine: Can reduce haloperidol's effectiveness. Your doctor will adjust the plan if both are needed.

What your doctor will monitor

  • Movement side effects should be discussed at every appointment
  • Weight, blood sugar, and cholesterol checked periodically
  • ECG in patients with cardiac risk factors
  • Formal movement assessment every 6 to 12 months for long-term users

What happens if you stop taking it?

Never stop haloperidol suddenly without medical guidance. A rapid return of psychotic symptoms may follow. Your doctor will plan any reduction carefully.

What you should know about this medicine in Kenya

Haloperidol is the most accessible antipsychotic in Kenya, available from health centre level. For many families across the country, it represents the primary pharmacological option for managing acute psychosis and schizophrenia.

The long-acting depot injection form is particularly important in Kenya, where daily oral adherence can be challenging. A monthly injection converts a daily task into a scheduled clinic visit.

Biperiden, used to manage movement side effects, is also listed in the Kenya EML and should be available at the same facilities as haloperidol.

References

  1. Ministry of Health, Kenya. (2023). Kenya Essential Medicines List 2023. Nairobi: Ministry of Health.
  2. Ministry of Health, Kenya. (2023). Kenya National Medicines Formulary, 1st Edition. Nairobi: Ministry of Health.
  3. Leucht, S., et al. (2013). Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia. The Lancet, 382(9896), 951-962.
  4. World Health Organization. (2023). Model List of Essential Medicines, 23rd Edition. Geneva: WHO.