... 60 minutes? Patient is 88 years old with probable dementia .limited oral communication and is unable to eat, dress, or move without help.
Has anyone ever heard of using Haldol 5 mg at bedtime for sleep and rest with a may repeat in 30 to?
Question posted by jubee50 on 1 June 2011
Last updated on 4 May 2012
3 Answers
DzooBaby
1 June 2011
5 mg is not that high of a dose. It will help with agitation. Some of these elderly folks tend to "Sundown" meaning their agitation grows worse in the evenings to nights. The haldol given only at night is for this. Many dementia patients are calm during the day then become different people at night. I've seen folks who are normal and lucid during the day, become severly agitated and confused during the night. Their families may not even know this if they were not around them much during the nighttime hours. It can be very scary for the patients too. Haldol used to be used very frequently in nursing homes in the eighties and nineties then the government decided it was a "chemical restraint" and nursing homes had to stop using restraints of all kinds.
A person had a "right" to fall out of bed and break a hip! We had to take all the people off their sleeping meds and their antianxiety meds as well as the antipsychotics because all of these could be classed as "chemical restraints". Even folks who had been on them for years and even stuff like Benedryl. We had to prove in writing we gave them a trial run of stopping the meds. It was absolutely crazy and you guys know what happens when you cold turkey people off meds like these!!! It was insane! In some ways, I guess, it was a good thing becuase I'm sure there were folks who were overmedicated but for the majority, it was pretty crazy. People ended up falling, breaking hips, and never recovering. Now there is a shift back again to using these types of medications that helped those with agitated dementia calm down. Drs are seeing the value of these kinds of meds again. I think judicious use is the key. If he is not agitated dont give it. If he is, give the medicine and take the time to observe and see how he does. I would give it the full hour before I redosed with the second 5mg. Poor man! I really hope I dont live long enough to become that way. I could write a book with the stuff I've seen over the years!! Some of it is very funny and a lot of it is so sad it would break your heart! I am glad I have had the opportunity to have my life enriched by having known a lot of these folks. It is never dull work that's for sure! I hope the medicine can help this man with his quality of living. Also remember that many folks with dementia cannot express themselves when they are in pain and agitation is their only way to express pain. When I see a person becoming agitated I try giving some acetaminophen, or whatever they have ordered, to see if that helps first. If it is pain they are experiencing, they will calm after the pain medicine. I would try this before I tried the Haldol. Just a tip from long time experience! Good luck!
Inactive
1 June 2011
Thank you for the info DzooBaby. I guess the old cliche' that you learn something new everyday, is right! -Alem
Inactive
1 June 2011
I concur. Thanks Dzoobaby, appreciated.
DzooBaby
2 June 2011
No problem! Actually I think the max dose is 100mg per day (by mouth-IV and IM doses are different) 5mg 2-3 x daily are starting doses.
jsr2861
5 May 2012
my mother is 83 yrs old, has dementia/alzhiemers. She is in a nursing facility and they have been giving her Haldol when needed, recently they started giving it to her twice daily and as needed. For the past 3 weeks now she has become incoherant most of the time, makes no sense when talking, can hardly walk and will NOT sleep at night. She is exremely anxious, not wanting to sit still for any length of time. Her tongue is constantly out and moving. I'm wondering why they keep giving it to her when the FDA does not recommend it. Has anyone else had this problem. I don't want her to die because the nursing facility doesn't have the time or staff to tend to her. They tell me if they take her off this medication and she "acts" out they will remove her from the facility.
Inactive
1 June 2011
I'm going to agree with Pledge and say that does seem like a high dose. I have a 13 year old neice who takes Haldol. Of course given her age and weight her dose is much smaller. I would suggest calling the pharmacist and see what they think. They sometimes know more about proper dosing than the doctors. I'm sorry I couldn't give you a more definitive answer. Good Luck-Alem
Inactive
1 June 2011
Hi Alem. Good to you, and glad that you also think its high, I never thought to suggest the pharmacist, good point. Very, true they often do seem to know more than some doctors. In an older text book of mine, and I meant to say this but I wasn't very clear in what I said so heres goes ... for elderly patients(with dementia) its started at 0.5 to 1mg once or twice a day. In other people its started at 5mg twice or three times per day, and if the person is not responding well enough, may be raised as high as 60mg per day. However, its recommened that a daily dose be kept to 30mg. That seems to be the norm. Best of wishes.
Inactive
1 June 2011
Hello jubee50. Not sure if I can answer your question. I know its given to elderly people who do have dementia, and its started at 0.5 to 1mg once or sometimes twice a day. I was on haldol some years ago. My dose ended up being 30 and 35mg. I understand the 5mg at bedtime but to possibly repeat it again within an hour. I'm not a dr. I can only guess, and give my opinion, as an outsider looking in, but I'd say given the patients age, that would be a strong dose, if it were given so close together. And maybe its that the patient is not responding to the 5mg, and by having it given again so close together, trying to get the person to respond. Just guesses. Not being very helpfull here, but I do hope that this person does hopefully become a bit better. I have a cousin, only at 65 years of age, and her dementia began less than three years ago. Its progressed so rapidly, she now, needs help in dressing, bathing and so on. Its a terrible illness, and its so heart breaking to watch. very best of wishes go out to you and this person.
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Further information
- Haldol uses and safety info
- Haldol prescribing info & package insert (for Health Professionals)
- Side effects of Haldol (detailed)
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