Haldol, or haloperidol, is an antipsychotic medication. It is used to treat psychotic symptoms, which include hallucinations, delusions and detachment from reality. Its use can be short or long term. Short term side effects include a number of neurological symptoms that can be very uncomfortable to the patient, but can be alleviated successfully with proper treatment.
Treatment of Acute Dystonia
Acute dystonia refers to a sudden spasm of the muscles, causing an increased tone and severe rigidity. The jaws may become locked, and the eyes may roll back in the head and become locked in that position. Dystonia is a painful condition, as well as alarming to the patient. It can also be life threatening, since the spasm can involve the muscles of the larynx and prevent air from entering the lungs. According to the Canadian Movement Disorder Group, haloperidol is one the medications most likely to cause this reaction. Treatment consists of discontinuing haloperidol and giving an anticholinergic medication immediately. Commonly used anticholinergic medications are Cogentin, or benztropine, and Benadryl, or diphenhydramine. To treat acute dystonia they are given intravenously or intramuscularly. Once the acute crisis is over, anticholinergic medications should be continued in pill form, and a different medication should be chosen to treat the psychotic symptoms.
Treatment of Akathisia
Akathisia refers to an uncomfortable sense of internal restlessness, accompanied by constant movement of the legs or pacing back and forth. Akathisia can be relieved by reducing the dose of haloperidol to the minimum necessary to control symptoms, and adding other medications to treat this symptom. According to "Kaplan and Sadock's Textbook of Psychiatry," treatment options include propranolol, a beta-blocker, or benzodiazepines, such as lorazepam or clonazepam. Medications are given by mouth, and used on a regular basis, several times a day.
Treatment of Parkinsonian Symptoms
Haloperidol is a potent blocker of dopamine receptors. As a result, it causes symptoms similar to those of Parkinson's, a disease in which dopamine nerve cells are destroyed. Symptoms include slowed movement, tremor and rigidity. According to "Kaplan and Sadock's Textbook of Psychiatry," treatment consists of scheduled doses of an anticholinergic medication, such as cogentin. Doses range from 0.5 mg to 2mg, given several times a day. Anticholinergic medications can cause various symptoms including blurry vision, difficulty urinating and confusion, and should be used with caution in elderly patients.
Tardive dyskinesia is a movement disorder that appears after long term use of haloperidol. Symptoms consist of involuntary, constant movements, most often of the tongue, mouth, and hands. According to "Kaplan and Sadock's Textbook of Psychiatry," there is no effective treatment. According to the "National Institutes of Neurological Disorders and Stroke," drugs such as benzodiazepines and propranolol may be beneficial, though treatment is highly individualized.
- "Kaplan and Sadock's Comprehensive Textbook of Psychiatry"; Virginia Sadock and Pedro Ruiz (editors); 2009
- Canadian Movement Disorder Group: Acute Dytonia
- National Institutes of Neurological Disorders and Stroke: Tardive Dyskinesia