I'm a nursing student, and I would like to respond to #66966 on haldol
and the elderly.

Organization: Florida State University - School of Higher Thought
News-Software: VAX/VMS VNEWS 1.4-b1  

First, I'm sorry to hear that you have had to see your grandmother go
through this.  I know it has to have been tough.

There are many things that can cause long term confusion in elderly
{*filter*}s.  The change in environment can cause problems.  Anesthetic agents
can cause confusion because the body cannot clear the medicines out of
the body as easily.  In addition, medications and interactions between
medications can cause confusion.

As far as whether or not haldol can have long lasting effects even after
the drug has been discontinued, I do not know.  I have not _seen_ anything
to that effect.  However, I also had not been looking for that information.
I can see what I can find...

I can tell you that haldol is an antipsychotic drug, and, according to
the Nursing93 Drug handbook, it is "Especially useful for agitation
associated with senile dementia"  (p. 400).  It also should not be
discontinued abruptly.  It did not say anything about long lasting
effects.

Because so many things can cause confusion, it is hard for me to know
what else was going on at the time; if I had more history, i might be able
to answer you better.  If you want to send me e-mail with more information,
I would be happy to try to  help you piece together what might have
happened.

Elisa

The original poster did not say why his mother had been in hospital
but I can answer a few general points.

Elderly patients may exhibit a marked difficulty in coping after
being in hospital for a few days. The drastic change of environment
will often unmask how marginally they have been coping at home. Even
young people find the change unsettling.

Though we have thought that this decrement in function after - say -
anaesthesia and surgery for a fractured hip (a common event in the
elderly) was due to anaesthesia there is good evidence that the
change of situation is much more important. Some hospitals have
tried a 'rapid transit' system for hip fractures, aiming to have the
patient back at home within 24 hours of admission. The selection of
the anaesthetic has no effect on the ability to discharge these
patients early.

Anaesthetists who work with the elderly (which is almost all of us)
generally take care to tailor the choice and dose of {*filter*} used to
the individual patient. Even so, there is some evidence that full
mental recovery may take a surprisingly long time to return. This is
the sort of thing which is detected by setting quite difficult
tasks, not the gross change that the original poster noted.

Haloperidol (Haldol TM) is a long acting drug. The plasma half life
of the drug is up to 35 hours. If the decanoate (a sort of slow
release formulation) is used it may be weeks. The elderly are
sensitive to haloperidol for a number of reasons. Without knowing
more it is hard to comment.

Don Mackie - his opinions
esiology will disavow...