Haloperidol - Questons/Opinions ??

Discussion in 'ARCHIVE FORUM: Support discussions' started by stardust123, May 17, 2008.

  1. stardust123

    stardust123 Registered User

    Apr 11, 2008
    16
    My Dad, who has been diagnosed with dementia, was admitted to hospital about 7 weeks ago, had an infection in his foot which caused him to collapse. Whilst they were waiting to treat his infection, Dad was very agitated and confused. We and the Doctors seemed to think that he was more so due to the infection. He was put on haloperidol 3 days after entering hospital (at this point his foot was still infected, hence accounting for the confusion/.agitation etc).

    After the infection was treated, my Dad seemed much better, the only effect was his short term memory was really bad. We only found out a few weeks ago that he had been placed on haloperidol 3 days after entering hospital, apparently the notes say it was discussed with the family at the time, errr no !!!!!

    It's now 6 weeks later and he's still in hospital, he's still on Haloperidol. The decline in my Dad has been phenominal. He's still in hospital, but sometimes thinks he's abroad, in a police station, in a cafe. Yesterday he thought I was Mom. Been to see him today and he just looks lost. Also, slow to think and slow to make conversation.

    I find it hard to believe that his condition could have just
    deteriorated 'naturally' in the space of a few weeks as the hospital seem to think. Could haloperidol have anything to do with the way he is? From the info I've read, I thought that this drug was only supposed to be given as and when, not every day (2.5mg twice a day) as they are giving my Dad at the minute.

    We raised the issue with the hospital and they said it was quite a low dosage and shouldn't really be causing any probs.

    Any advice welcome - thanks !
     
  2. gigi

    gigi Registered User

    Nov 16, 2007
    7,788
    East Midlands
    Hello Stardust,

    Infection usually causes an increase in confusion..even if there is no dementia.

    How was your dad before the infection?

    If he was relatively stable I'd be inclined to think that this drug is being administered to "keep him manageable"..

    My best advice would be to see his consultant..or one of the medical team..and direct your concerns to them.

    You say you've raised the issue with the hospital..who was that..? Try raising it again. If your dad has a consultant relating to his dementia it may be worth contacting him/her too with your concerns. Hope this is of some help..

    Love gigi xx
     
  3. alfjess

    alfjess Registered User

    Jul 10, 2006
    1,213
    south lanarkshire
    Hi Stardust

    I would be very wary of Haloperidol after my experience of Mum being prescibed it in the psychiatrict assessment ward.

    She became increasingly sedated, until eventually she wasn't mobile. She was a size 16 before being admitted to hospital, but was a size 8/10 after only 9 weeks

    Watch for the anti-psychotic stoop! Mum was stooped 90 degrees, almost at right angles from the waist and also listing to the side, although the nurses told me, that normally the stoop was only from the neck. She couldn't speak, couldn't feed herself, became incontinent and the consultant told me "she didn't have long"

    Mum was moved to a NHS continuing care home,in the middle of January, where she was weaned of Haloperidol.
    Although still wearing incontinence pads, she can now walk, feed herself, and to begin with sometimes understand and answer questions.
    Unfortunately her severe agitation has returned and she is now being prescribed amisulphiride(sp) She is still on her feet, but quite sedated, slightly stooped but not as bad as she was when taking Haloperidol.

    I know Haloperidol has helped some and I don't want to be a scaremonger, but I think all carers should be aware, that some anti-psychotics do more harm than good to dementia sufferers.

    I think there is information on the Alzheimer's web site regarding this.

    Take care
    Alfjess
     
  4. Taffy

    Taffy Registered User

    Apr 15, 2007
    1,314
    Hello,

    Sorry to hear that your dad isn't doing so great infection can cause confusion as does taking them out of their familiar surrounds. I know with my dad when ever he was away in hospital he became very confused and once home within a few days he was better.

    My experience with Haloperidol refers to my mum and it worked very well for her agitation she was prescribed .5mg once daily for three days. When mum entered the Care Home she needed to have it again for agitation and was given 2.5mg I questioned the dosage and like you was assured it was a very small dose and she would have it for three days and then stopped. Mum had a really bad fall and ended up in hospital for 11 days the Dr's told me 2.5mg is a small dose but not for a dementia sufferer in mum's case it was like a overdose.

    Mum had a brain scan because she had concussion and it showed a brain bleed that was around three days old this is what more than likely caused the agitation in the first place but that wasn't possible to detect then. In hospital they continued with the haloperidol .5mg for two days and mum settle and was compliant unlike your dad she didn't have infection. Infection can cause havoc.

    Hope that your dad soon recovers. Take Care, Taffy.
     
  5. Canadian Joanne

    Canadian Joanne Volunteer Moderator

    Apr 8, 2005
    16,142
    Toronto, Canada
    With the experience we had with halperidol with my mother, I would be very very cautious. It is an older drug and I did not like the effect on my mother. It turned her into a zombie.

    This is not an "as required" drug. This is a drug meant to be given on a regular basis. If you don't like the effects it is having on your dad, why not ask the doctor to prescribe something else instead? Plus, halperidol takes time to completely leave a person's system.

    If you feel strongly about it, push for a change. Push politely, civilly, smilingly but push!
     
  6. Carolynlott

    Carolynlott Registered User

    Jan 1, 2007
    232
    Newcastle upon Tyne
    My Dad was put on Haloperidol and Lorazepam when he became very aggressive and totally unmanageable in January after 4 weeks in his CH. They calmed him down a great deal - but he is now being weaned off the Haloperidol. He has deteriorated considerably over these months. He no longer recognises me or remembers anything about his family. He lives in a world which bears no relationship to reality. They are trying to give him the Lorazepam later in the evening in order to help him sleep. However I visited today at 10.30-ish and he was fast asleep in bed having had a "very active" night.

    Now the aggression signs are returning - he is cross and agitated most of the time, so who knows what will happen next.

    He was sent to hospital with a suspected DVT this week - they kept him waiting 3 hours for a scan by which time he was climbing the walls and fighting people with his walking stick. When I visited on Wednesday he had just fallen and split his forehead open. This is all on top of the double fracture of the arm he suffered when he went into respite last December. I sometimes feel so bad that I haven't been able to prevent any of this happening to him and that if things had been the other way round he would have looked after me.

    It never gets any easier - you just have to try and get better at pushing it to the back of your mind.
     
  7. Natashalou

    Natashalou Registered User

    Mar 22, 2007
    426
    london
    My mother took this drug for the last year, but on being admitted to hospital earlier in the week it has been discontinued. She is now out of hospital and in my view much much worse without the drug than she was with it.
     
  8. CraigC

    CraigC Registered User

    Mar 21, 2003
    6,630
    London
    Sorry I'm a bit late catching this thread.

    Firsly let me say that I have seen a few people posting and saying that antipsychotics have really helped cope with aggressive or agitated behaviour.

    However, my dad was put on Haloperidol many years ago. Like you it was NOT discussed with the family, the GP and the home just went ahead and told us when we questioned his decline. He had a very bad reaction to haloperidol and it just completely knocked him for six (it was also a low dosage). He just withdrew and stared into space. We had a bit of a battle but it was withdrawn and replaced with quetiapine which in his particular case worked better.

    My arguement has always been that these medications may be OK in the short term, but should be reviewed regularly. In my opinion (and please note I am not a medical professional) these powerful drugs should only be used in the short term if at all. Every case is different but I am sure there are many with dementia who do not get their medication reviewed regularly if at all.

    BTW - dad is now off quetiapine, and to this day I am convinced this medicated was unecessarily after the first two months. He is now more alert and comfortable without the drugs. People with dementia get confused and agitated particulary when personal care is involved or there are big life changes. Drugs are often an easy answer and that is the danger.

    Again, not speaking as a medical professional and every case is different. You could start off by asking the hospital what harm it would do to reduce the dose further or at least withdraw it slowly and see what happens. Also ask them what the long term plan is with his medication. I really regret not doing this years ago. Also, if you can find the time keep a diary of the changes, medication doses etc.

    If you are interested in finding out more about the use of antipsychotics for people with dementia, you may like to check out this thread:

    http://www.alzheimers.org.uk/talkingpoint/discuss/showthread.php?t=8905

    It gives details of a report that discussed the implications and dangers of over-prescribing neuroleptics / antipsychotics.

    Kind Regards
    Craig
     
  9. stardust123

    stardust123 Registered User

    Apr 11, 2008
    16
    Hi

    Thanks all for your comments. Have been trying to get to see a doctor now since Monday. No doctor to be found on ward after 4.30 p.m. I can't get there during the day. They won't discuss anything with me on the phone. GRRRRRRRRRRR !! Will somehow have to get there in the morning and going to ask if they can try some other drug and wean him off the haloperidol. I fail to see how someone can decline so much within a month, the hospital just say that it is his condition declining. Is 2.5 mg twice a day a lot for a dementia patient do you think? I noticed on the drugs chart tonight that someone had requested that it go down to 1.5mg but it seems that 'someone' has overidden this and said it should be 2mg. Just really fed up with hospitals thinking they can just go merrily along treating a patient, making a whole folder full of notes and yet not telling the family anything. Sorry, fed up.
     
  10. alfjess

    alfjess Registered User

    Jul 10, 2006
    1,213
    south lanarkshire
    Hi Stardust

    I can sympathise with you re. Doctors.

    I could only speak to Mum's consultant at the hospital, if I made an appointment, first thing on a Wednesday morning, because, that was the only time he visited the ward.

    Also, same as you, they changed Mum's Meds and if I didn't ask, I was never told. The amount of info I was given was dependent on the nurse in charge, if they could be bothered, at the time of asking.

    Mum was prescibed Haloperidol, PRN, "or as required", sometimes I was told this had been reduced, sometimes I was told it was the same, but with a maximum per day?? Not being a medic I didn't know any better, but in hindsight, I think I should have been more questioning in their care and medicating of my Mum

    At least in the NHS continuing care home (different consultant) they are trying to find a balance between, severely agitated and keeping her on her feet. Doesn't always work, but at least they try.

    take care
    Alfjess
     

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