Haldol is available in sterile vials containing 5 mg strength Haldol per 1 ml of fluid used for injection. Usual starting dose is -5 mg intramuscularly. Dose may vary according to patient response to the drug. Switch to an oral form of this drug is recommended as soon as possible. Haldol may interact with other drugs so the patient needs close observation or monitoring to determine if other side effects develop. Haldol should only be used during pregnancy or in women likely to become pregnant only if the benefit clearly justifies a potential risk to the fetus; fetal abnormalities and fetal exposure to Haldol in the third trimester have shown dependence at birth. Women who are breastfeeding should not take Haldol because the drug may affect the infant. Although reports of use for behavior modification exist, the drug is not approved for use in children.
“The behavioral approaches I know of would be to first try to assess the cause(s) for her distress: Is it pain? (So, UTI or constipation possible? Is she eating/drinking enough, could a medication be causing the problem?) Or are perceptual changes causing a fear of the water (common) or of falling as she tries to sit, or of falling in?
Worth considering: When does the distress begin? When they start to lead her to the toilet, once she’s in the room trying to sit, or after she’s seated? Could assists like a higher seat or frame around the commode help ease anxiety of falling as she sits? What might be happening when this older person is “misinterpreting”? Could it also be an anxiety about privacy?
It’s also possible that now a negative association has been set up with whoever is leading her to the bathroom, and the whole business is an unpleasant experience for her. That might warrant a whole different approach –not, “time to use the toilet” but sort of cajoling her along and just happening to be there, inviting her to sit, etc. which can be a very time intensive process; if the caregiver is stressed or rushing or tense about it, she’ll pick up on that. Might warrant an entirely different person and approach to doing this, which isn’t always feasible.”
The intravenous route is not FDA approved and is generally not recommended except when no other alternatives are available. Intravenous administration appears to be associated with a higher risk of QT prolongation and torsade de pointes (TdP) than other forms of administration. The manufacturer recommends ECG monitoring for QT prolongation and arrhythmias if IV administration is required. A dose in the range of 1 to 5 mg IV has been suggested, with the dose being repeated at 30 to 60 minute intervals, if needed. A maximum IV dose has not been established. The lowest effective dose should be used in conjunction with conversion to oral therapy as soon as possible.