-- Robert Preidt
TUESDAY, Aug. 20 (HealthDay News) -- Haloperidol, an
antipsychotic drug that's widely used in hospitals to treat
delirium in critically ill patients, is no more effective than a
placebo, a new study contends.
Delirium is common in critically ill patients, and those who
develop the condition are up to three times more likely to die
within the next six months than those who do not. Delirium also
adds to the stress and discomfort of both patients and their
In this study, British researchers looked at 141 critically ill
patients on breathing machines who received either haloperidol
(Haldol) or a placebo.
Over 14 days, treatment with haloperidol had no effect on the
number of days that patients had delirium.
Over 28 days, getting treated with haloperidol failed to reduce
death rates, time spent on ventilators, or the length of time
patients spent in the hospital or in critical care, according to
the study, which was published online Aug. 20 in
The Lancet Respiratory Medicine.
Patients who received haloperidol did seem to require less
sedation than those given a placebo. According to the researchers,
that suggests that the drug may help to ease short-term
However, even though there is "limited eveidence" in its favor,
"increasing numbers of patients are being exposed to haloperidol
for the management of delirium," study leader Dr. Valerie Page, of
Watford General Hospital, said in a journal news release. "Our
results suggest a commonly used haloperidol dose regimen does not
decrease delirium in critically ill patients requiring mechanical
ventilation, when commenced early during ICU stay."
"Our results do not support the idea that haloperidol modifies duration of delirium in critically ill patients," Page said.
One expert said a closer examination of the use of the drug is
"Given the cocktail of sedating medications critically ill patients receive, the addition of another -- haloperidol in this case -- must warrant benefit," said Dr. Bradley Flansbaum, a hospitalist at Lenox Hill Hospital in New York City.
However, in the new trial "the patients had outcomes no
different than placebo," he said. "Should critically ill folks
receive haloperidol? For acute episodes of agitation or cognitive
[mental] impairment -- yes, assuming no contraindications to the
But when it comes to using haloperidol for routine prevention of
delirium, the answer to that question is "no," Flansbaum added.
Another expert writing in an editorial in the journal
"Although haloperidol is used commonly, its use to treat delirium does not seem to be justified," wrote Dr. Yoanna Skrobik, critical care chair at the University of Montreal.
Skrobik questioned whether delirium even needs to be treated
"Only non-pharmacological prevention measures have been shown to reduce its occurrence in critically ill patients," she said. "Non-pharmacological interventions are effective in numerous psychiatric and psychological disturbances. The challenge lies in the distress delirium symptoms cause in caregivers. We should be asking ourselves, are we treating the patients or our own discomfort?"
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