What dosing range is suggested for first-generation antipsychotics like Haloperidol to balance response and adverse effects?

• A. 0.5-2 mg/day
• B. 2-10 mg/day
• C. 40-100 mg/day
• D. 20-60 mg/day

Answer: (B)

The key idea is finding a dose that provides symptom relief without triggering too many side effects, especially extrapyramidal symptoms (EPS) common with first‑generation antipsychotics. Haloperidol is a potent D2 blocker, so even small increases in dose can markedly raise EPS risk. The range around 2–10 mg per day tends to offer meaningful antipsychotic effects for many adults while keeping EPS and other adverse effects more manageable. Lower than this often yields subtherapeutic response, while much higher doses (like 20 mg/day or more) substantially raise the likelihood of rigidity, akathisia, dystonia, and tardive dyskinesia. In practice, start low and titrate gradually to the lowest effective dose, commonly achieving control within this 2–10 mg/day window. Elderly or frail patients may need even lower starting doses and slower titration.