We converted all antipsychotic doses to chlorpromazine ...



Calculation of CPZ Equivalents

We convert all antipsychotic doses to chlorpromazine equivalents, using published equivalencies for oral conventional (American Psychiatric Association 1997) and atypical (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) (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) (Schooler and Levine 1976). For risperidone, 25 mg depot/2 weeks per 2 mg/d orally is used (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 Code |Trade Name |Generic Name |Equivalent dose |

|01 |Haldol |haloperidol |2 mg per day |

|02 |Thorazine |chlorpromazine |100 mg per day |

|03 |Mellaril |thioridazine |100 mg per day |

|04 |Navane |thiothixene |4 mg per day |

|05 |Risperdal |risperidone (oral) |2 mg per day |

|06 |Zyprexa |olanzapine |5 mg per day |

|07 |Prolixin |fluphenazine (oral) |2 mg per day |

|08 |Stelazine |trifluoperazine |2 mg per day |

|09 |Trilafon |perphenazine |8 mg per day |

|10 |Moban |molindone |10 mg per day |

|11 |Loxitane |loxapine |10 mg per day |

|12 |Compazine |prochlorperazine |15 mg per day |

|13 |Seroquel |quetiapine |75 mg per day |

|13 |Serentil |mesoridazine |50 mg per day |

|15 |Clozaril |clozapine |50 mg per day |

|17 |Geodon |ziprasidone |60 mg per day |

|17 |Haldol dec |haloperidol (depot) |30 mg per 28 days |

|18 |Prolixin dec |fluphenazine (depot) |2.5 mg per 21 days |

|19 |Abilify |aripiprazole |7.5 mg per day |

|20 |Risperdal Consta |risperidone (depot) |25 mg per 14 days |

Table 2. Antipsychotics and Equivalent Doses (sorted by trade name)

|Proposed Code |Trade Name |Generic Name |Equivalent dose |

|19 |Abilify |aripiprazole |7.5 mg per day |

|15 |Clozaril |clozapine |50 mg per day |

|12 |Compazine |prochlorperazine |15 mg per day |

|17 |Geodon |ziprasidone |60 mg per day |

|01 |Haldol |haloperidol |2 mg per day |

|17 |Haldol dec |haloperidol (depot) |30 mg per 28 days |

|11 |Loxitane |loxapine |10 mg per day |

|03 |Mellaril |thioridazine |100 mg per day |

|10 |Moban |molindone |10 mg per day |

|04 |Navane |thiothixene |4 mg per day |

|07 |Prolixin |fluphenazine (oral) |2 mg per day |

|18 |Prolixin dec |fluphenazine (depot) |2.5 mg per 21 days |

|05 |Risperdal |risperidone (oral) |2 mg per day |

|20 |Risperdal Consta |risperidone (depot) |25 mg per 14 days |

|13 |Serentil |mesoridazine |50 mg per day |

|13 |Seroquel |quetiapine |75 mg per day |

|08 |Stelazine |trifluoperazine |2 mg per day |

|02 |Thorazine |chlorpromazine |100 mg per day |

|09 |Trilafon |perphenazine |8 mg per day |

|06 |Zyprexa |olanzapine |5 mg per day |

Table 3. Antipsychotics and Equivalent Doses (sorted by generic name)

|Proposed Code |Trade Name |Generic Name |Equivalent dose |

|19 |Abilify |aripiprazole |7.5 mg per day |

|02 |Thorazine |chlorpromazine |100 mg per day |

|15 |Clozaril |clozapine |50 mg per day |

|18 |Prolixin dec |fluphenazine (depot) |2.5 mg per 21 days |

|07 |Prolixin |fluphenazine (oral) |2 mg per day |

|01 |Haldol |haloperidol |2 mg per day |

|17 |Haldol dec |haloperidol (depot) |30 mg per 28 days |

|11 |Loxitane |loxapine |10 mg per day |

|13 |Serentil |mesoridazine |50 mg per day |

|10 |Moban |molindone |10 mg per day |

|06 |Zyprexa |olanzapine |5 mg per day |

|09 |Trilafon |perphenazine |8 mg per day |

|12 |Compazine |prochlorperazine |15 mg per day |

|13 |Seroquel |quetiapine |75 mg per day |

|20 |Risperdal Consta |risperidone (depot) |25 mg per 14 days |

|05 |Risperdal |risperidone (oral) |2 mg per day |

|03 |Mellaril |thioridazine |100 mg per day |

|04 |Navane |thiothixene |4 mg per day |

|08 |Stelazine |trifluoperazine |2 mg per day |

|17 |Geodon |ziprasidone |60 mg per day |

Table 4. Antipsychotics and Equivalent Doses (sorted by equivalent dose)

|Proposed Code |Trade Name |Generic Name |Equivalent dose |

|01 |Haldol |haloperidol |2 mg per day |

|05 |Risperdal |risperidone (oral) |2 mg per day |

|07 |Prolixin |fluphenazine (oral) |2 mg per day |

|08 |Stelazine |trifluoperazine |2 mg per day |

|04 |Navane |thiothixene |4 mg per day |

|06 |Zyprexa |olanzapine |5 mg per day |

|19 |Abilify |aripiprazole |7.5 mg per day |

|09 |Trilafon |perphenazine |8 mg per day |

|10 |Moban |molindone |10 mg per day |

|11 |Loxitane |loxapine |10 mg per day |

|12 |Compazine |prochlorperazine |15 mg per day |

|13 |Serentil |mesoridazine |50 mg per day |

|15 |Clozaril |clozapine |50 mg per day |

|17 |Geodon |ziprasidone |60 mg per day |

|13 |Seroquel |quetiapine |75 mg per day |

|02 |Thorazine |chlorpromazine |100 mg per day |

|03 |Mellaril |thioridazine |100 mg per day |

|18 |Prolixin dec |fluphenazine (depot) |2.5 mg per 21 days |

|17 |Haldol dec |haloperidol (depot) |30 mg per 28 days |

|20 |Risperdal Consta |risperidone (depot) |25 mg per 14 days |

References

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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