Haloperidol for agitation in persons with dementia.

Abstract

Haloperidol for Agitation in Persons with Dementia Agitation and other behavioural symptoms occur in up to 92% of persons with Dementia. Haloperidol, a typical antipsychotic, has been used for many years to control agitation in persons with dementia but its efficacy and safety remains unclear. Thus, the research question of this study: "Is Haloperidol effective in reducing agitation in persons with dementia residing in long term care?'' The Population is agitated elderly patients with dementia, the intervention is Haloperidol in agitated residents with dementia, the comparison is to give Haloperidol vs Placebo, and the outcome is to reduce agitation. The studies reviewed included double blind studies related to the drug Haloperidol and other antipsychotics in the management of behavioural psychological symptoms of dementia including agitation, that were published between the year 1990 and 2012. Moreover, studies related to physical restrain; studies focusing only on the effectiveness of other antipsychotics which are not Haloperidol; and non-English Language studies were excluded. One SR and five RCTs were used for the conduction of this review. CASP tools were the main methods used to appraise the articles. According to the studies reviewed, Haloperidol varies in its effectiveness according to dose studied. An increase in extrapyramidal side effects was noted in persons taking Haloperidol when compared to a placebo. Administering Haloperidol in moderate doses is effective in reducing agitation at the cost of extrapyramidal side effects. As a result Haloperidol needs to be used for no longer than 12 weeks whilst the dose prescribed should be individualised and carefully monitored. Nurses and physicians need to be more aware of its side effects by attending further training. Further research about person-centred non-pharmacological interventions that control agitation in dementia are urgently needed. Keywords: HALOPERIDOL, AGITATION, BEHAVIOURAL SYMPTOMS, ELDERLY PERSONS, EXTRAPYRAMIDAL SYMPTOMS, DEMENTIA B.Sc (Hons.) Nursing April 2012