Haloperidol in the Psychiatric Disorders of Old Age

Sugerman, A. Arthur; Williams, Benjamin H.; Adlerstein, Arthur M.

doi:10.1176/ajp.120.12.1190

Cited by 54 publications

(17 citation statements)

References 2 publications

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“…27,31,33 In 3 other studies, the number of deaths in the groups was likely to be zero because no dropouts were reported. 21,22,25 For the 5 remaining trials, the number of deaths was assumed to be zero because deaths were not reported despite elaborate information on other adverse effects. 23 A total of 32 deaths occurred in the 17 RCTs: 17 in the active treatment groups, and 15 in the placebo groups.…”

Section: Resultsmentioning

confidence: 99%

The Mortality Risk of Conventional Antipsychotics in Elderly Patients: A Systematic Review and Meta-analysis of Randomized Placebo-Controlled Trials

Hulshof

Zuidema

Ostelo

et al. 2015

Journal of the American Medical Directors Association

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Section: Resultsmentioning

confidence: 99%

The Mortality Risk of Conventional Antipsychotics in Elderly Patients: A Systematic Review and Meta-analysis of Randomized Placebo-Controlled Trials

Hulshof

Zuidema

Ostelo

et al. 2015

Journal of the American Medical Directors Association

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“…In a group of 18 demented state hospital patients, haloperidol (3.0 to 4.5 mg per day) significantly reduced symptoms of hallucinations, overactivity, and uncooperativeness 36 . Side effects such as drowsiness, unsteadiness, and extrapyramidal reactions were common in the haloperidol group.…”

Section: Neurolepticsmentioning

confidence: 96%

Pharmacologic Treatment of Agitation Associated With Dementia

Risse

Barnes

1986

J American Geriatrics Society

120

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Pharmacotherapy of aggressive or agitated behaviors in the dementia patient has not been studied extensively, despite the prevalence of this problem. Neuroleptics have the most support for efficacy, with shorter acting benzodiazepines demonstrating benefit on occasion. However, studies done to date indicate that these drugs are effective only for a minority of patients and that side effects frequently make patients worse. Other medications, such as propranolol, carbamazepine, or lithium, may be helpful, but their efficacy in dementia patients has not been demonstrated in placebo-controlled studies. Until such studies are done, their use is most appropriate in special patient groups or in patients who have failed neuroleptic or benzodiazepine treatment. More studies are needed in elderly patients evaluating effectiveness of pharmacologic agents in specific types of dementia, particularly Alzheimer's disease. Most studies done to date have been of relatively short duration, usually two months or less. Because these medications often are given to dementia patients for prolonged periods, studies are needed to define the long-term clinical efficacy of these agents. In the clinical setting, these agents should be reduced periodically or discontinued to determine ongoing need. In addition, environmental, social, or behavioral methods of reducing agitated behaviors need to be explored as an adjunct to any medication trial.

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“…Results from studies comparing cognitive function before and after the use of neuroleptics have been conflicting. Some studies have not shown any effect on global assessments,10 16 17 others have found improvements in memory or orientation,18 19 20 21 22 and some have shown a worsening of cognitive function 11 23…”

Section: Introductionmentioning

confidence: 99%

Do neuroleptic drugs hasten cognitive decline in dementia? Prospective study with necropsy follow up

McShane

Keene

Gedling

et al. 1997

BMJ

227

127

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Objective: To determine whether treatment with low dose aspirin and heparin leads to a higher rate of live births than that achieved with low dose aspirin alone in women with a history of recurrent miscarriage associated with phospholipid antibodies (or antiphospholipid antibodies), lupus anticoagulant, and cardiolipin antibodies (or anticardiolipin antibodies). Design: Randomised controlled trial. Setting: Specialist clinic for recurrent miscarriages. Subjects: 90 women (median age 33 (range 22-43)) with a history of recurrent miscarriage (median number 4 (range 3-15)) and persistently positive results for phospholipid antibodies. Intervention: Either low dose aspirin (75 mg daily) or low dose aspirin and 5000 U of unfractionated heparin subcutaneously 12 hourly. All women started treatment with low dose aspirin when they had a positive urine pregnancy test. Women were randomly allocated an intervention when fetal heart activity was seen on ultrasonography. Treatment was stopped at the time of miscarriage or at 34 weeks' gestation. Main outcome measures: Rate of live births with the two treatments. Results: There was no significant difference in the two groups in age or the number and gestation of previous miscarriages. The rate of live births with low dose aspirin and heparin was 71% (32/45 pregnancies) and 42% (19/45 pregnancies) with low dose aspirin alone (odds ratio 3.37 (95% confidence interval 1.40 to 8.10)). More than 90% of miscarriages occurred in the first trimester. There was no difference in outcome between the two treatments in pregnancies that advanced beyond 13 weeks' gestation. Twelve of the 51 successful pregnancies (24%) were delivered before 37 weeks' gestation. Women randomly allocated aspirin and heparin had a median decrease in lumbar spine bone density of 5.4% (range − 8.6% to 1.7%). Conclusion: Treatment with aspirin and heparin leads to a significantly higher rate of live births in women with a history of recurrent miscarriage associated with phospholipid antibodies than that achieved with aspirin alone.

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Haloperidol in the Psychiatric Disorders of Old Age

Cited by 54 publications

References 2 publications

The Mortality Risk of Conventional Antipsychotics in Elderly Patients: A Systematic Review and Meta-analysis of Randomized Placebo-Controlled Trials

The Mortality Risk of Conventional Antipsychotics in Elderly Patients: A Systematic Review and Meta-analysis of Randomized Placebo-Controlled Trials

Pharmacologic Treatment of Agitation Associated With Dementia

Do neuroleptic drugs hasten cognitive decline in dementia? Prospective study with necropsy follow up

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