Effect of Lorazepam With Haloperidol vs Haloperidol Alone on Agitated Delirium in Patients With Advanced Cancer Receiving Palliative Care: A Randomized Clinical Trial -

Effect of Lorazepam With Haloperidol vs Haloperidol Alone on Agitated Delirium in Patients With Advanced Cancer Receiving Palliative Care: A Randomized Clinical Trial
Information type: Randomised controlled trials
Source: Journal of the American Medical Association
Specialities: Cancers | Mental health and illness | Palliative and End of Life Care
Summary
This small RCT (n=52) reports addition of lorazepam 3mg iv to haloperidol resulted in a greater reduction of Richmond Agitation Sedation Scale score at 8 hours (−4.1 points) than placebo + haloperidol (−2.3 points) (mean difference, −1.9 points [95% CI −2.8 to −0.9]; P <0.001).
UKMi comment

In a related editorial, the authors note that the combination of haloperidol + lorazepam did not treat delirium, but rather masked hyperactive delirium symptoms by sedating the patients and, more likely, converting those patients to hypoactive delirium.

The authors also present risks associated with addition of lorazepam in this patient population, advising that the results of this study are not generalisable.
Related links: Editorial