From the Guidelines
Haloperidol (Haldol) should not be used as a first-line treatment for gastroparesis, and its use is not recommended due to the lack of evidence supporting its efficacy and potential side effects, as evidenced by the most recent study 1. The treatment of gastroparesis typically involves medications that accelerate gastric emptying, such as metoclopramide, domperidone, and erythromycin, as well as medications for nausea and vomiting, such as ondansetron and prochlorperazine 1. Some key points to consider when treating gastroparesis include:
- Metoclopramide is the only FDA-approved medication for gastroparesis, but its use is recommended for no more than 12 weeks due to the risk of serious adverse effects 1.
- Domperidone and erythromycin are alternative treatment options, but their use is limited by availability and efficacy 1.
- Gastric electrical stimulation is a treatment option for severe gastroparesis that is refractory to other treatments, but its efficacy is variable 1.
- Patients with gastroparesis should be monitored for side effects, including sedation, extrapyramidal symptoms, QT prolongation, and tardive dyskinesia, especially with long-term use of medications like metoclopramide 1. It is essential to prioritize the use of evidence-based treatments for gastroparesis, and haloperidol is not a recommended treatment option due to the lack of evidence supporting its efficacy and potential side effects 1.
From the Research
Treatment of Gastroparesis
- Gastroparesis is a neuromuscular disorder of the upper gastrointestinal tract, with symptoms including early satiety, postprandial fullness, nausea, and vomiting 2.
- The current FDA-approved pharmacologic agent for the treatment of gastroparesis is metoclopramide 2, 3, 4.
Use of Haloperidol in Gastroparesis Treatment
- A randomized controlled double-blind trial compared haloperidol combined with conventional therapy to conventional therapy alone in patients with symptomatic gastroparesis, and found that haloperidol as an adjunctive therapy was superior to placebo for acute gastroparesis symptoms 5.
- The study found that the reductions in symptom scores, including pain and nausea, were statistically significant in the haloperidol group but not in the placebo group 5.
- There is evidence to suggest that haloperidol can be used for the treatment of gastroparesis, particularly for acute symptoms 5.
Alternative Treatment Options
- Other treatment options for gastroparesis include domperidone, which has been shown to improve symptoms of gastroparesis, including early satiety, postprandial fullness, and nausea 6, 3.
- Cisapride has also been found to have beneficial effects on gastric motility with long-term therapy 3.
- The choice of treatment should be tailored according to symptoms as well as physiologic abnormalities 4.