Haloperidol (Delirium)
Brand names: Haldol, Serenace
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.
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.
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.
- Richmond Agitation-Sedation Scale (RASS) · Sedation Assessment
- Confusion Assessment Method for ICU (CAM-ICU) · Delirium Assessment
- PICU Delirium Assessment (pCAM-ICU) · Delirium Assessment
- 4AT — Rapid Assessment for Delirium · Diagnosis
- Confusion Assessment Method (CAM) · Cognitive Assessment
- 4AT Delirium Assessment Tool · Delirium
- Falls Assessment in Older Adults · NICE CG161 2013
- Delirium Outside ICU · NICE CG103
- Comprehensive Geriatric Assessment (CGA) · BGS / NICE
- Delirium Assessment and Management · NICE CG103 2010
- Frailty Recognition and Management · BGS Frailty Framework / NHS NHSE
- Polypharmacy and Medicines Optimisation · STOPP/START v2 2014 / NICE NG5