Adding Lorazepam to Haloperidol Might Help Alleviate Agitated Delirium in Advanced-Cancer Patients

Nearly all terminally ill patients experience episodes of delirium, usually with agitation and restlessness, and they often are treated with haloperidol. When haloperidol is insufficient, some clinicians add a benzodiazepine (e.g., lorazepam), but others are reluctant to do so because of reported side effects. In this trial conducted in an acute palliative care unit at Houston's MD Anderson Cancer Center, 90 advanced-cancer patients (all with histories of agitated delirium), received intravenous (IV) haloperidol (2 mg every 4 hours; plus 2 mg additional, hourly as needed); if haloperidol failed to control agitation, patients were randomized to receive either IV lorazepam (3 mg) or placebo. All patients were treated for reversible causes of …