Indications: maintenance in schizophrenia and related psychoses particularly with apathy but not mania or psychomotor hyperactivity; anxiety.

Cautions: with the high doses, periodic blood counts are needed. Another antipsychotic drug should be used if agitation or aggression appears; porphyria. Hepatic & renal impairment, cardiovascular disease, Parkinson’s disease, epilepsy.

Contra-indications: excitable or overactive patients.

Side Effects: extra pyramidal symptoms consisting of parkinsonian symptoms, dystonia, dyskinesia, restlessness, tardive dyskinesia.

Dose: Deep IM injection into the gluteal muscle, test dose 20 mg then after 5-10 days 20-40 mg repeated at intervals of 2-4 weeks, adjusted according to the, response; max. 400 mg weekly. usual maintenance dose 50 mg every 4 weeks to 300 mg every 2 weeks; ELDERLY initially quarter to half adult dose.