Molindone

MOBAN

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Pronunciation: moe-LIN-doen

Molindone ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Molindone ballicule

Molindone MOBAN mascot mnemonic cartoon — Visual mnemonic: Molindone mascot
**“Mole Dome Mole ban”**
Spooky mascot → antipsychotic
Yardstick → short half-life
Banned mole → not withdrawn from market but intermittently unavailable

What it isFirst-generation D2-antagonist antipsychotic for schizophrenia.

Why this oneTends to cause less weight gain than many antipsychotics, but has no unique efficacy advantage.

What limits itExtrapyramidal symptoms, akathisia, hyperprolactinemia, and multiple-daily dosing limit use.

Molindone molecular structure (skeletal formula) — Molecular structure: Molindone

Molindone prescription history

Animated chart of estimated U.S. prescriptions per year, Antipsychotics (1954–2026). Molindone enters in 1974 (estimated).

FDA-approved for

schizophrenia (~1974)

Classes and tags

Clinical profile

Therapeutic safety burden2 / 4

Overdose danger2 / 4

Weight-gain liability1 / 4

Sedation liability1 / 4

QT / Torsades1 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk2 / 4

Legacy pregnancy categoryC

Defining liabilityMetabolic effects, extrapyramidal symptoms/tardive dyskinesia and agent-specific QT or orthostatic risk.

FDA label

Read the full label on DailyMed ↗

BOXED WARNING Increased mortality in elderly patients with dementia-related psychosis; not approved for dementia-related psychosis.

FDA dosing	Population	Start	Target	Max
Psychotic disorder (antipsychotic)	Adult	50–75 mg/day		225 mg/day (severe)

Titration Increase to 100 mg/day in 3–4 days.

Renal Undefined

Hepatic Undefined

Instructions

Individualize initial and maintenance doses.
Maintenance given in 3–4 divided doses per day.
Elderly and debilitated patients should start at lower dosage.

Available strengths

tab 5, 10, 25 mg

Contraindications

Severe CNS depression (alcohol, barbiturates, narcotics) or comatose states.

Cautions

Tardive dyskinesia
Extrapyramidal symptoms (akathisia, parkinsonism, dystonia)
Drowsiness
Anticholinergic effects (urinary retention, constipation)
Neonatal EPS/withdrawal with third-trimester exposure

Adverse reactions

Initial drowsiness
Depression
Hyperactivity
Euphoria
Extrapyramidal symptoms
Blurred vision
Tachycardia
Dry mouth
Nausea

Pregnancy Animal studies show no teratogenic potential; third-trimester exposure risks neonatal EPS/withdrawal; use only if benefit justifies risk.

Lactation Undefined

Cost

Molindone (MOBAN)

Strength		#/mo	CostPlus
5 mg	tab	per unit	not offered
10 mg	tab	per unit	not offered
25 mg	tab	per unit	offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Molindone is dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

Generic entry2015

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Memory aids: interaction avatars

Box: minimal PK interactions

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Self-check

What weight advantage can molindone offer?
Less weight gain than many antipsychotics.
What dosing burden limits molindone?
Multiple-daily dosing.