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To the Editor.—
I have read the article in The Journal (240:380, 1978), "Treatment of the Agitated Patient With an Organic Brain Disorder." I strongly agree with the text of the article, but I would like to make three comments. First, haloperidol works best with those organic brain disorders that manifest paranoid thinking. In my clinical experience, this is true regardless of the cause or causes of the paranoid organic brain syndrome. Second, I would caution those physicians who are treating patients with chronic obstructive pulmonary disease or otherwise compromised pulmonary function. I agree that haloperidol is probably the best choice, since its effect on blood pressure is minimal, but I have found that some patients become extremely somnolent even with low doses, eg, 1 mg intra-muscularly every four to six hours. The dosage of haloperidol for these patients is often much lower than it is for patients with other
Davis JA. Haloperidol for Organic Brain Disorders. JAMA. 1979;241(15):1575–1576. doi:10.1001/jama.1979.03290410015012