The FDA just came out with an FDA ALERT warning healthcare providers about the use of Haldol.
Based on an Italian study in 2005, there may be a link between Haldol and Torsades de Pointes/QT prolongation. In addition, there were “at least 28 case reports” of Torsades and QT prolongation with Haldol use. Knock me over with a feather.
Now there is a recommendation that EKG monitoring be performed on anyone receiving IV Haldol.
Haldol was approved by the FDA in 1988. Nineteen years and probably tens of millions of doses later we are able to come up with a whole 28 case reports that may link Haldol to prolonged QT syndromes? Impressive.
Notice how the ALERT states
Based on case reports alone, we are unable to estimate the frequency with which QT prolongation or TdP occur following administration of these drugs.
Doesn’t matter. Just blast this medication the same way you blasted Droperidol with no scientific basis.
So now I have some questions.
If the FDA was so concerned for patient safety, why did it wait for two years before posting its FDA ALERT? The study which forms the basis for its ALERT was published in 2005.
Did anyone notice that the Italian study cited used Haldol decanoate – the long-acting version of the drug? No one gives that IV.
Did anyone notice that the study cited by the FDA was sponsored by Johnson & Johnson? Janssen Pharmaceuticals is one of Johnson & Johnson’s partners and makes a product named Zyprexa that competes with Haldol. Zyprexa has sales of more than $2 billion per year. Don’t suppose that sales of Zyprexa will be hurt by the FDA’s shock statement about Haldol usage.
Interesting NY Times article from 2003 showing how these antipsychotic drugs are a huge moneymaker for pharmaceutical companies. The article notes that
For the price of treating one person with Zyprexa at $303 for a month’s prescription, he said, or two on Risperdal, at $159 per month, the state could treat 8 or 10 people with Haldol at $35 per month.
Zyprexa and Risperdal have been linked to early onset diabetes and DEATH, but there is no “FDA ALERT” that we have to do Hemoglobin A1c levels or blood glucose levels before giving them. Risperdal is also linked to strokes, but there is no “FDA ALERT” that we have to do a CT scan on every patient before we give it. Why all the fuss about Haldol?
Want me to stop using Haldol? Here’s my proposal to patients:
Stop coming into my emergency department as an angry drunk or a combative drug abuser. Stop trying to assault me or my staff. Cooperate with us while we try to help you. Then I won’t have to use Haldol on you and everyone will be happy – except maybe Johnson & Johnson.