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Haloperidol Medication can cause Severe or Fatal Reactions

Categories: Medications

The Question

Is Haloperidol a safe medication to treat symptoms of agitation by individuals with traumatic brain injury?

Past Studies

Past Studies state that diffuse axonal injuries are present in up to one-third of all traumatic brain injuries. A diffuse axonal injury can occur during powerful turning movements of the head, such as with a car crash. This forceful movement causes brain structures to tear. This can result in extensive injury to nerve tissue throughout the brain. Otherwise contained brain chemicals can be released, causing additional injury. The tearing of the nerve tissue and release of brain chemicals disrupts the brain’s regular communication and chemical processes. In particular, the brain’s dopamine system can be affected. Dopamine is a chemical that carries messages in the brain. Dopamine is responsible for controlling body movements, alertness, attention, and emotional reactions. Diffuse axonal injuries have been linked with a decrease in the amount of brain signals carried by dopamine. Some medications used to treat the symptoms of brain injury can even make the damaged dopamine system even worse. 

This study

This study presents the case of one individual with a traumatic brain injury and diffuse axonal injury. Twelve days after the individual’s injury date, he received Haloperidol to treat his agitation. The individual then developed a high fever, sweating, fast heart rate, and began thrashing his arms and legs. He also experienced a decrease in alertness, thinking skills, strength, endurance, and the ability to position and move his body. The Haloperidol had caused him to develop a harmful and sometimes fatal condition called Neuroleptic Malignant Syndrome (NMS). The physicians stopped giving the individual Haloperidol. They treated his symptoms and placed him on different medications. The individual made rapid gains and returned to home at 38 days from his injury date. He regained his ability to think and walk.

Who May Be Affected By These Findings

Individuals with traumatic brain injury and their loved ones, healthcare professionals, and researchers.

Caveats

Animal studies have shown that Haloperidol can cause NMS. This case study is the first that shows how Haloperidol may increase the incidence of NMS for individuals with traumatic brain injury.

Bottom Line

Haloperidol was not a safe medication to treat the agitation of the individual in this case study. The use of Haloperidol for individuals with traumatic brain injury remains controversial. The researchers suggest that other medications should be considered first. They state that Haloperidol, and medications in this drug class, should be considered only when individuals are at severe risk of hurting themselves or others.

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Find This Study

Wilkinson, R., Meythaler, J.M., & Guin-Renfroe, S. (1999). Case study: Neuroleptic malignant syndrome induce by haloperidol following traumatic brain injury. Brain Injury, 13, 1025-1031.