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Typical Antipsychotic (Butyrophenone)

Haloperidol (Delirium)

Brand names: Haldol, Serenace

Used in: Delirium & Cognitive Impairment

Haloperidol is a first-generation (typical) antipsychotic used in schizophrenia and mania, and short-term for severe agitation or distress in delirium when non-drug measures have failed.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

DOSAGE AND ADMINISTRATION There is considerable variation from patient to patient in the amount of medication required for treatment. As with all antipsychotic drugs, dosage should be individualized according to the needs and response of each patient. Dosage adjustments, either upward or downward, should be carried out as rapidly as practicable to achieve optimum therapeutic control. To determine the initial dosage, consideration should be given to the patient's age, severity of illness, previous response to other antipsychotic drugs, and any concomitant medication or disease state. Children, debilitated or geriatric patients, as well as those with a history of adverse reactions to …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2024-11-15. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It is a potent dopamine D2 antagonist.

Prescribing in practice

  • Extrapyramidal effects (acute dystonia, parkinsonism, akathisia) and QT prolongation are prominent; be alert to neuroleptic malignant syndrome.
  • Avoid in Parkinson's disease and dementia with Lewy bodies (severe sensitivity); in delirium use the lowest dose for the shortest time after addressing causes.
  • Antipsychotics increase stroke and mortality risk in older people with dementia.

Monitoring

Monitor for extrapyramidal effects and (where relevant) ECG/QT; in delirium review the need to continue daily.

Counselling the patient

  • It is used short-term for severe agitation.
  • Report muscle stiffness, abnormal movements, or a high fever.
  • Drowsiness can occur.

Evidence & guidelines

An option for short-term management of distress/agitation in delirium after non-drug measures (NICE CG103); avoided in Parkinson's and Lewy body disease, with EPSE and QT cautions.

Reference: NICE NG212 (delirium); HOPE-ICU trial; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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