Haldol (haloperidol) vs. Xanax (alprazolam): What's the difference?

  • Haloperidol and Xanax (alprazolam) are used to treat different types of psychiatric disorders.
  • Haloperidol is used to treat schizophrenia, acute psychosis, and for tics and vocal utterances of Tourette's syndrome.
  • Xanax is used to treat anxiety disorders and panic attacks.
  • A brand name for haloperidol is Haldol.
  • Haloperidol and Xanax belong to different drug classes. Haloperidol is an antipsychotic medication and Xanax is a benzodiazepine-type anti-anxiety drug.
  • Side effects of haloperidol and Xanax that are similar include tiredness/fatigue, drowsiness/sedation, changes in weight, dry mouth, and constipation.
  • Side effects of haloperidol that are different from Xanax include extrapyramidal effects (sudden, often jerky, involuntary motions of the head, neck, arms, body, or eyes; muscle stiffness, restlessness, Parkinsonism), dizziness, hyperactivity, nausea, erectile dysfunction, menstrual irregularities, insomnia, swelling of breast tissue in males (gynecomastia), vomiting, and dizziness on standing during the first few weeks of treatment.
  • Side effects of Xanax that are different from haloperidol include memory problems, speech problems, and headache.
  • Do not stop using haloperidol or Xanax suddenly, or you could have unpleasant withdrawal symptoms.

What is haloperidol? What is Xanax?

Haloperidol is an antipsychotic medication used for treating psychiatric disorders such as schizophrenia, acute psychosis, and also to treat tics and vocal utterances of Tourette's syndrome. Haloperidol interferes with the effects of neurotransmitters (specifically the dopamine and serotonin type 2 receptors) in the brain. Haloperidol blocks receptors for the neurotransmitters on the nerves. As a result, the nerves are not "activated" by the neurotransmitters released by other nerves.

Xanax (alprazolam) is a benzodiazepine type anti-anxiety medication used to treat anxiety disorders and panic attacks. Other benzodiazepines include diazepam (Valium), clonazepam (Klonopin), lorazepam (Ativan), flurazepam (Dalmane), and others. Xanax and other benzodiazepines act by enhancing the effects of the neurotransmitter gamma-aminobutyric acid (GABA) in the brain. It is believed that excessive activity in the brain may cause anxiety or other psychiatric disorders.

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What are the side effects of haloperidol and Xanax?

Haloperidol

The most common side effects associated with Haldol are:

  • extrapyramidal effects (sudden, often jerky, involuntary motions of the head, neck, arms, body, or eyes, muscle stiffness, akathisia, Parkinsonism),
  • dizziness,
  • hyperactivity,
  • tiredness, and
  • nausea.

Other important side effects are:

Haldol may cause a condition called "orthostatic hypotension" during the early phase of treatment (first week or two). Orthostatic hypotension causes patients to become dizzy upon arising from a lying or sitting position because of a drop in blood pressure.

Haldol also may cause abnormal heart beats, sudden death, seizures, decreases in red and white blood cells, and withdrawal symptoms.
Elderly patients with dementia-related psychosis and treated with antipsychotic drugs such as Haldol are at an increased risk of death.

Xanax

The most common side effects of Xanax taken at lower doses are:

Other side effects include:

What is the dosage for haloperidol vs. Xanax?

Haloperidol

  • The recommended oral dose for schizophrenia is 0.5-5 mg two or three times daily up to a maximum dose of 30 mg daily. The lactate solution dose is 2-5 mg every 4-8 hours as needed by intramuscular injection. The lactate solution may also be administered by intravenous injection at 1-2 mg every 2-4 hours and titrated to effect. The maximum single injection dose is 50 mg and the maximum daily dose is 500 mg daily. The dose for the decanoate solution is 10-20 times the daily oral dose once monthly by intramuscular injection. The decanoate solution should not be administered intravenously.
  • The recommended dose for treating Tourette's syndrome is 0.5-5 mg orally two or three times daily.

Xanax

  • The starting dose for treating anxiety is 0.25-0.5 mg 3 to 4 times daily using immediate release tablets. The dose may be increased every 3-4 days to a maximum dose of 4 mg daily.
  • The starting dose for treating panic attacks is 0.5 mg 3 times daily. Doses can be increased every 3-4 days but by no more than 1 mg daily.
  • The effective dose for preventing panic attacks may be as high as 10 mg daily for some patients. The starting dose when using extended release tablets to treat panic disorder is 0.5 mg once daily and the average dose is 3-6 mg once daily.
  • Alprazolam may be taken with or without food.

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What drugs interact with haloperidol and Xanax?

Haloperidol

Haldol causes sedation, and sedation may be greater if Haldol is taken with alcohol and other drugs that can cause sedation such as the benzodiazepine class of anti-anxiety drugs for example:

  • diazepam (Valium)
  • lorazepam (Ativan)
  • clonazepam (Klonopin)
  • alprazolam (Xanax)

The narcotic class of pain medications and its derivatives for example:

The tricyclic class of antidepressants for example:

Some antihistamines for example:

Certain antihypertensive medications for example:

Carbamazepine (Tegretol) may increase the elimination of Haldol, rendering the Haldol less effective. Rifampin (Rifadin) may decrease the elimination of Haldol, increasing the risk of side effects from Haldol.

Xanax

  • Ketoconazole (Nizoral), itraconazole (Sporanox), nefazodone (Serzone), cimetidine (Tagamet), and fluvoxamine (Luvox) increase concentrations in the blood of alprazolam and therefore may increase the side effects of alprazolam.
  • Alprazolam interacts with alcohol and medications (for example, barbiturates, and narcotics) that suppress activity in the brain by suppressing activity more and causing sedation.
  • Carbamazepine and rifampin reduce the effect of alprazolam by increasing metabolism and elimination of alprazolam in the liver.

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Are haloperidol and Xanax safe to use while pregnant or breastfeeding?

Haloperidol

  • Neonates exposed to antipsychotics during the 3rd trimester of pregnancy may develop withdrawal symptoms and extrapyramidal symptoms.
  • Haldol is secreted into breast milk. It should not be used while breast feeding.

Xanax

  • Benzodiazepines, such as alprazolam, can cause fetal abnormalities and should not be used in pregnancy.
  • Alprazolam is excreted in breast milk and it can affect nursing infants. Therefore, women who are should not take alprazolam while breastfeeding.

Summary

Haldol (haloperidol) vs. Xanax (alprazolam) are used to treat different types of psychiatric disorders. Haloperidol is used to treat schizophrenia, acute psychosis, and for tics and vocal utterances of Tourette's syndrome. Xanax is used to treat anxiety disorders and panic attacks.

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Medically Reviewed on 8/1/2019
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