Haloperidol in the Emergency Department Setting

From Psychiatry Advisor:

Since the 1980’s, intramuscular (IM) haloperidol has been a mainstay of emergency rooms (ERs) and psychiatric facilities. Frequently given as part of a cocktail with lorazepam (often known as the “B-52” or “HAC”), it has been a default treatment, along with physical restraints, for patients with acute agitation in these settings.

But for more than a decade, newer, yet equally potent agents with better side effect profiles have been available, to the point that modern best-practices guidelines encourage these approaches over the traditional haloperidol.1 Of these, oral, inhaled and sublingual medications may be the most patient-friendly, whereas for cases when injections are still necessary, atypical antipsychotics offer efficacy with less oversedation and fewer untoward outcomes.2

Yet despite these alternative recommendations, many sites are still persisting in the use of IM haloperidol.3

If your site is among these holdouts, here are 8 good reasons to advocate moving forward to more contemporary medication strategies:

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