A pilot study of haloperidol treatment of psychosis and behavioral disturbance in Alzheimer's disease

D. P. Devanand, H. A. Sackeim, R. P. Brown and R. Mayeux
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY.

Nine outpatients meeting research criteria for probable Alzheimer's disease who had psychosis or behavioral disturbance participated in a single-blind, placebo-controlled pilot study. Oral haloperidol in doses of 1 to 5 mg daily improved target symptoms, confirmed by double-blind ratings of videotaped interviews. Patients could not be maintained on more than 4 mg of haloperidol daily due to the severity of extrapyramidal side effects. Modified Mini-Mental State scores worsened while taking haloperidol, with only partial recovery in the final 4-week placebo phase. Severe extrapyramidal side effects and decline in cognitive function may compromise the efficacy of commonly used doses of neuroleptic drugs in patients with Alzheimer's disease.

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