molindone MOBAN

Class: First Generation Antipsychotic/​Dihydroindolone
FDA Indications: Schizophrenia
Off-Label Use: Impulsive Aggression In ADHD
Prescribing
Forms: 5, 10, 25, 50mg tablet
Dose Range: 50-225 mg/day
Starting: The usual starting dosage is 50-75 mg/day. Increase to 100 mg/day in 3 or 4 days. Based on severity of symptomatology, dosage may be titrated up or down depending on individual patient response. An increase to 225 mg/day may be required in patients with severe symptomatology.
Stopping: Taper 6-8 weeks, rapid d/c can lead to rebound psychosis
Monitoring:

NAMI drug fact sheet

Precautions
Contraindications: Contraindicated in severe central nervous system depression (alcohol, barbiturates, narcotics, etc.) or comatose states
Serious Side Effects: , , Neutropenia and/or Agranulocytosis (rare), Rare, transient, non-specific T wave Δ's have been reported (association with a clinical syndrome has not been established), Hyperprolactinemia
Drugs to Avoid in Congenital Long QT
Side Effects: akathisia, rash, EPS, drowsiness, lenticular opacities, amenorrhea (rare)
Pharmacodynamics
1° MOA: Dopamine 2 (D2) receptor antagonism in mesolimbic area
Target: D1 (low), D2 (very high), α1 (low), H1 (very low)
Pharmacokinetics
t½: 12 (6-24)° TMAX: 0.5-2°
Substrate of: 2D6
Inhibits: ∅ ; Induces:
Active Metabolites: Some of its 36 metabolites may be active.
DDIs
Misc
  • - medium potency typical antipsychotic
  • - structurally unrelated to any of the other marketed neuroleptics
  • - has no appreciable affinity at serotonin, cholinergic, adrenergic, or histaminergic receptors
  • - more likely to cause weight loss than weight gain
Special Populations

Category C—Studies in pregnant patients have not been carried out. Animal reproductive studies have not demonstrated a teratogenic potential. The anticipated benefits must be weighed against the unknown risks to the fetus if used in pregnant patients.

Data are not available on the content of molindone in the milk of nursing mothers.

Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Elderly and debilitated patients should be started on lower dosage.

No dosage adjustment necessary.


No dosage adjustment necessary

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Last updated August 27 2018 18:45:06. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.