![]() Diagnosis and treatment of newly presenting delirium in elderly people can be challenging as it is often multifactorial.Ĭlinical guidance recommends that patients are reviewed, and screening tools used. Clinical advice available on treatment of deliriumĭelirium or ‘acute confusional state’ is a common and complex condition that is known to occur more frequently in older people. This advice is consistent with current clinical advice for management of delirium in this population. We issue this reminder to healthcare professionals, especially prescribers of haloperidol, to emphasise the need for special caution when using this medicine in elderly people. However, the review identified that the practical use of haloperidol in patients with delirium is variable and is known to be especially associated with adverse effects of the central nervous system. The review did not identify any new safety concerns relating to use of haloperidol in elderly patients and no changes will be made to the safety advice in the product information. We have made available a Public Assessment Report. We sought advice on the review assessment from the Pharmacovigilance Expert Advisory Group of the Commission on Human Medicines and experts in neurology and psychiatry. The review included safety data from the Yellow Card scheme as well the published literature and current clinical guidance. The MHRA conducted a review of UK safety information for haloperidol in the treatment of delirium in frail, elderly patients. The MHRA received concerns from a patient representative regarding the use of haloperidol for the acute treatment of delirium in elderly people in the UK. Haloperidol is a first-generation antipsychotic authorised for treatment of neurological and psychiatric disorders, including the acute treatment of delirium in adults when non-pharmacological treatments have failed – see the Summary of Product Characteristics (SmPC) for full indications. Review of haloperidol use in elderly patients with delirium report suspected adverse reactions associated with haloperidol on a Yellow Card.monitor for and investigate early any extrapyramidal adverse effects, such as acute dystonia, parkinsonism, tardive dyskinesia, akathisia, hypersalivation, and dysphagia.prescribe the lowest possible dose for the shortest possible time, ensuring that any dose up-titration is gradual and reviewed frequently.before initiating treatment, a baseline electrocardiogram (ECG) and correction of any electrolyte disturbances is recommended cardiac and electrolyte monitoring should be repeated during treatment (see below).only consider haloperidol for delirium when non-pharmacological interventions are ineffective and no contraindications are present (including Parkinson’s disease and dementia with Lewy bodies). ![]() special caution is required when using haloperidol for the acute treatment of delirium in frail, elderly patients.
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