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Calculation of CPZ Equivalents
We convert all antipsychotic doses to chlorpromazine equivalents, using published equivalencies for oral conventional ADDIN EN.CITE American Psychiatric Association199773000000000730American Psychiatric Association,1997Practice Guideline for the Treatment of Patients with SchizophreniaAmerican Journal of Psychiatry1544 Suppl1-63(American Psychiatric Association 1997) and atypical ADDIN EN.CITE Woods200318400000000184Woods, S.W.2003Chlorpromazine equivalent doses for the newer atypical antipsychoticsJournal of Clinical Psychiatry64663-667(Woods 2003) antipsychotics. For depot haloperidol, fluphenazine, and risperidone, we use the manufacturers recommended equivalent for the depot to oral conversion for the same drug and then converted to oral chlorpromazine equivalents. For haloperidol the manufacturer recommends that 10-15 mg per 4 weeks is equivalent to 1 mg/d orally. We use the 15 mg figure. This estimate is supported by a bioavailability study (mean 14.1 mg depot/4 weeks per 1 mg/d orally) ADDIN EN.CITE Nayak198745300000000453Nayak, R. K.Doose, D. R.Nair, N. P.The bioavailability and pharmacokinetics of oral and depot intramuscular haloperidol in schizophrenic patientsJ Clin Pharmacol1987272144-50AdultAgedBiological AvailabilityChromatography, High Pressure LiquidHaloperidol/ad [Administration & Dosage]*Haloperidol/pk [Pharmacokinetics]HumanInjections, IntramuscularMiddle AgeSchizophrenia/dt [Drug Therapy]*Schizophrenia/me [Metabolism](Nayak et al 1987). For fluphenazine the manufacturer recommends 12.5 mg depot/3 weeks as equivalent to 10 mg/d orally. This estimate is supported by a dose comparison study (12.5 mg depot/3 week equivalent to approximately 9 mg/d orally) ADDIN EN.CITE Schooler197624300000000243Schooler, N. R.Levine, J.1976Initiation of long-term pharmacotherapy in schizophrenia - Dosage and side-effect comparisons between oral and depot fluphenazinePharmakopsychiatrie Neuro-Psychopharmakologie94159-69(Schooler and Levine 1976). For risperidone, 25 mg depot/2 weeks per 2 mg/d orally is used ADDIN EN.CITE Chue2005283400000002834Chue, P.Eerdekens, M.Augustyns, I.Lachaux, B.Molcan, P.Eriksson, L.Pretorius, H.David, A. S.Comparative efficacy and safety of long-acting risperidone and risperidone oral tablets2005European Neuropsychopharmacology151111-7(Chue et al 2005).
The following Tables have been created based on the references above.
Table 1. Antipsychotics and Equivalent Doses (sorted by med code)
Proposed CodeTrade NameGeneric NameEquivalent dose01Haldolhaloperidol2 mg per day02Thorazinechlorpromazine100 mg per day03Mellarilthioridazine100 mg per day04Navanethiothixene4 mg per day05Risperdalrisperidone (oral)2 mg per day06Zyprexaolanzapine5 mg per day07Prolixinfluphenazine (oral)2 mg per day08Stelazinetrifluoperazine2 mg per day09Trilafonperphenazine8 mg per day10Mobanmolindone10 mg per day11Loxitaneloxapine10 mg per day12Compazineprochlorperazine15 mg per day13Seroquelquetiapine75 mg per day13Serentilmesoridazine50 mg per day15Clozarilclozapine50 mg per day17Geodonziprasidone60 mg per day17Haldol dechaloperidol (depot)30 mg per 28 days18Prolixin decfluphenazine (depot)2.5 mg per 21 days19Abilifyaripiprazole7.5 mg per day20Risperdal Constarisperidone (depot)25 mg per 14 days
Table 2. Antipsychotics and Equivalent Doses (sorted by trade name)
Proposed CodeTrade NameGeneric NameEquivalent dose19Abilifyaripiprazole7.5 mg per day15Clozarilclozapine50 mg per day12Compazineprochlorperazine15 mg per day17Geodonziprasidone60 mg per day01Haldolhaloperidol2 mg per day17Haldol dechaloperidol (depot)30 mg per 28 days11Loxitaneloxapine10 mg per day03Mellarilthioridazine100 mg per day10Mobanmolindone10 mg per day04Navanethiothixene4 mg per day07Prolixinfluphenazine (oral)2 mg per day18Prolixin decfluphenazine (depot)2.5 mg per 21 days05Risperdalrisperidone (oral)2 mg per day20Risperdal Constarisperidone (depot)25 mg per 14 days13Serentilmesoridazine50 mg per day13Seroquelquetiapine75 mg per day08Stelazinetrifluoperazine2 mg per day02Thorazinechlorpromazine100 mg per day09Trilafonperphenazine8 mg per day06Zyprexaolanzapine5 mg per day
Table 3. Antipsychotics and Equivalent Doses (sorted by generic name)
Proposed CodeTrade NameGeneric NameEquivalent dose19Abilifyaripiprazole7.5 mg per day02Thorazinechlorpromazine100 mg per day15Clozarilclozapine50 mg per day18Prolixin decfluphenazine (depot)2.5 mg per 21 days07Prolixinfluphenazine (oral)2 mg per day01Haldolhaloperidol2 mg per day17Haldol dechaloperidol (depot)30 mg per 28 days11Loxitaneloxapine10 mg per day13Serentilmesoridazine50 mg per day10Mobanmolindone10 mg per day06Zyprexaolanzapine5 mg per day09Trilafonperphenazine8 mg per day12Compazineprochlorperazine15 mg per day13Seroquelquetiapine75 mg per day20Risperdal Constarisperidone (depot)25 mg per 14 days05Risperdalrisperidone (oral)2 mg per day03Mellarilthioridazine100 mg per day04Navanethiothixene4 mg per day08Stelazinetrifluoperazine2 mg per day17Geodonziprasidone60 mg per day Table 4. Antipsychotics and Equivalent Doses (sorted by equivalent dose)
Proposed CodeTrade NameGeneric NameEquivalent dose01Haldolhaloperidol2 mg per day05Risperdalrisperidone (oral)2 mg per day07Prolixinfluphenazine (oral)2 mg per day08Stelazinetrifluoperazine2 mg per day04Navanethiothixene4 mg per day06Zyprexaolanzapine5 mg per day19Abilifyaripiprazole7.5 mg per day09Trilafonperphenazine8 mg per day10Mobanmolindone10 mg per day11Loxitaneloxapine10 mg per day12Compazineprochlorperazine15 mg per day13Serentilmesoridazine50 mg per day15Clozarilclozapine50 mg per day17Geodonziprasidone60 mg per day13Seroquelquetiapine75 mg per day02Thorazinechlorpromazine100 mg per day03Mellarilthioridazine100 mg per day18Prolixin decfluphenazine (depot)2.5 mg per 21 days17Haldol dechaloperidol (depot)30 mg per 28 days20Risperdal Constarisperidone (depot)25 mg per 14 days
References
ADDIN EN.REFLIST American Psychiatric Association (1997): Practice Guideline for the Treatment of Patients with Schizophrenia. American Journal of Psychiatry 154:1-63.
Chue P, Eerdekens M, Augustyns I, et al (2005): Comparative efficacy and safety of long-acting risperidone and risperidone oral tablets. European Neuropsychopharmacology 15:111-7.
Nayak RK, Doose DR, Nair NP (1987): The bioavailability and pharmacokinetics of oral and depot intramuscular haloperidol in schizophrenic patients. J Clin Pharmacol 27:144-50.
Schooler NR, Levine J (1976): Initiation of long-term pharmacotherapy in schizophrenia - Dosage and side-effect comparisons between oral and depot fluphenazine. Pharmakopsychiatrie Neuro-Psychopharmakologie 9:159-69.
Woods SW (2003): Chlorpromazine equivalent doses for the newer atypical antipsychotics. Journal of Clinical Psychiatry 64:663-667.
Scott W. Woods, M.D.
New Haven, Connecticut
November 15, 2005
scott.woods@yale.edu
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