Common antipsychotic fails as effective delirium treatment, study finds

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Haloperidol, a common antipsychotic, is no more effective than a placebo in treating delirium in critically ill patients, according to a new study.

Researchers studied more than 140 critically ill patients on ventilators. Each patient was either given haloperidol or a placebo. The British and American investigators found that after 14 days, the haloperidol had no effect on the number of days the patients had delirium.

They also found that after 28 days, those treated with the antipsychotic didn't have a reduced death rate. The drug also didn't reduce the time spent in the hospital or critical care, or the time a patient used a ventilator.

However, they did find that the drug offered a sedative side effect, which should come as no surprise to nursing home providers.

"Although haloperidol is used commonly, its use to treat delirium does not seem to be justified," wrote Yoanna Skrobik, M.D., critical care chairwoman at the University of Montreal. "Only non-pharmacological prevention measures have been shown to reduce its occurrence in critically ill patients…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?" she asked.

Providers already know antipsychotics' potential benefits do not outweigh their negative effects. The American Health Care Association's 15% reduction goal wasn't met earlier this year, but the organization has renewed its initiative.  

The study is available in The Lancet.