Schizophrenia. Effective in maintaining the clinical improvement during continuing therapy in patients who have shown initial treatment response. Short-term treatment of acute manic episode associated w/ bipolar I disorder. Prevent recurrence of manic, mixed or depressive episodes in bipolar I disorder.
Adult Monotherapy Initially 10 or 15 mg once daily. Maintenance: 5-20 mg once daily for 2 wk. Short-term (3-4 wk) antimanic efficacy 5-20 mg/day. Max: 20 mg/day. Adjunctive treatment to lithium or valproate Initially 10 mg once daily. Adolescent Bipolar I disorder Initially 2.5 or 5 mg once daily w/ target dose of 10 mg/day.
Increased risk of death & incidence of cerebrovascular events (eg, stroke, transient ischaemic attack) in elderly patients. Monitor for suicidal ideations. Discontinue if neuroleptic malignant syndrome & tardive dyskinesia develops. Monitor for symptoms of hyperglycemia; hyperlipidemia (include fasting blood lipid/glucose testing & lipid profiles at the beginning of & periodically during therapy); wt regularly. Patients w/ CV & cerebrovascular disease, conditons affecting hemodynamic responses; history of seizures or conditions that potentially lower seizure threshold; history of low WBC or drug-induced leukopenia/neutropenia. May elevate prolactin levels. Hepatic impairment. In combination w/ fluoxetine, lithium or valproate. May impair ability to drive & operate machinery.
Agitation or hostile, angry behavior, changes in emotions or behavior (depressed mood), restlessness or need to keep moving, stiffness, spasms, tremors or trembling; constipation, dizziness (especially on standing from sitting or lying position), drowsiness, dry mouth, lowered BP, runny nose, wt gain.
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