The efficacy of haloperidol in the management of nausea and vomiting in patients with cancer.
BACKGROUND
Haloperidol is used commonly for the control of nausea and vomiting (N/V) in palliative care patients, but there is very little evidence to support its use.


OBJECTIVE
To assess the efficacy of haloperidol as an antiemetic in patients with cancer and N/V not related to cancer treatment.


METHODS
Patients with an N/V score of at least 1 on a 4-point scale were prescribed either oral or subcutaneous haloperidol. N/V and toxicity were assessed daily for the duration of the study (maximum five days) by both the patient and an observer (health professional).


RESULTS
At Day 2, 33 of 42 (79%) treated patients were assessable for response. Eight (24%; 95% confidence interval [CI]: 10%-39%) patients had complete control of N/V and 12 (36%; 95% CI: 20%-53%) had partial control, giving an overall response rate of 61% (95% CI: 44%-77%). At Day 5, 23 patients were assessable for response. The overall response rate was 17 of 23 (74%; 95% CI: 56%-92%). If all patients are included in the response analysis, the overall response rates at Days 2 and 5 were 47% and 40%, respectively.


CONCLUSIONS
Haloperidol has some efficacy in the treatment of N/V in this patient group. The results from this uncontrolled study provide pilot data from which to plan future controlled trials of antiemetics in the palliative care population.
Hardy
Janet R
JR
Department of Palliative Care, Mater Health Services, South Brisbane, Queensland, Australia. janet.hardy@mater.org.au
O'Shea
Angela
A
White
Clare
C
Gilshenan
Kristen
K
Welch
Louise
L
Douglas
Carol
C
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000932:Antiemetics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D006220:Haloperidol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000150:complications* / Q000188:drug therapy*; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D010166:Palliative Care; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced / Q000150:complications* / Q000188:drug therapy*
D000932:Antiemetics; D000970:Antineoplastic Agents; D006220:Haloperidol