From the Guidelines
Haldol (haloperidol) is not recommended for treating insomnia. Haloperidol is an antipsychotic medication primarily used to treat conditions like schizophrenia, acute psychosis, Tourette's syndrome, and severe behavioral problems in some patients. It works by blocking dopamine receptors in the brain, which helps control psychotic symptoms but is not appropriate for sleep difficulties. While sedation can be a side effect of haloperidol, using it for insomnia would expose patients to unnecessary risks including potentially serious adverse effects such as extrapyramidal symptoms (movement disorders), QT prolongation (heart rhythm abnormalities), and tardive dyskinesia (involuntary movements that may become permanent) 1.
For insomnia, more appropriate first-line treatments include:
- Improving sleep hygiene
- Cognitive behavioral therapy for insomnia (CBT-I)
- If medication is needed, short-term use of medications specifically designed for sleep like certain benzodiazepines, non-benzodiazepine hypnotics (Z-drugs), or other options like low-dose doxepin, trazodone, or melatonin depending on the specific characteristics of the sleep problem 1.
The American College of Physicians recommends that all patients with chronic insomnia receive CBT-I as the initial treatment intervention, and pharmacologic therapy should only be considered if CBT-I is not effective 1. The use of antipsychotics, including haloperidol, for insomnia is not supported by evidence and is associated with significant risks 1.
Therefore, haloperidol should not be used to treat insomnia due to its potential for serious adverse effects and the availability of more effective and safer treatment options.
From the FDA Drug Label
Haloperidol tablets are indicated for use in the management of manifestations of psychotic disorders. Haloperidol tablets are indicated for the control of tics and vocal utterances of Tourette’s Disorder in children and adults Haloperidol tablets are effective for the treatment of severe behavior problems in children of combative, explosive hyperexcitability Haloperidol tablets are also effective in the short-term treatment of hyperactive children who show excessive motor activity with accompanying conduct disorders
The FDA-approved indications for Haldol (haloperidol) do not include insomnia or sleep disorders.
- The primary uses of Haldol are for managing psychotic disorders, Tourette's Disorder, and severe behavior problems in children. The dose of Haldol for sleep cannot be determined from the FDA drug label, as it is not an approved indication. 2
From the Research
Haldol for Sleep
- There is no direct evidence to support the use of Haldol (haloperidol) as a treatment for insomnia in the provided studies 3, 4, 5, 6, 7.
- The studies suggest that Cognitive Behavioral Therapy for Insomnia (CBT-I) is a highly effective treatment for insomnia, with no side effects and long-term improvements in sleep quality 3, 4, 5, 6.
- CBT-I is recommended as the first-line treatment for insomnia, and its use is supported by a large evidence base 3, 4, 5, 6, 7.
- Hypnotic medications may be considered as an adjunct treatment to CBT-I in some cases, but they do not address the underlying perpetuating factors of insomnia and may have potential side effects and dependence 7.
- There is no mention of Haldol (haloperidol) as a treatment for insomnia in the provided studies, suggesting that it is not a recommended or evidence-based treatment for this condition.
Alternative Treatments
- CBT-I is a multi-component treatment that targets difficulties with initiating and/or maintaining sleep, and is delivered over the course of six to eight sessions 5.
- The core components of CBT-I include Sleep Restriction Therapy, Stimulus Control Therapy, Sleep Hygiene, and Cognitive Therapy 5.
- CBT-I has been shown to be effective in reducing insomnia severity and improving mental health in patients with comorbid mental disorders, such as depression, PTSD, and alcohol dependency 4.