Question:
What does Haldol actually do to a person with HD? My husband was recently diagnosed with HD, his doctor has mentioned it, but just curious. I have not heard very many positive things about it.
Answer:
Haldol usually makes a person lethargic, sleeping a lot, losing interest in everything, seemingly/really? depressed plus long term use of this older-type medication can cause Tardive dyskinesia, Tardive dystonia and Neuroleptic Malignant Syndrome both devastating in themselves. Families have reported thinking an accelerated decline in a loved ones conditions was because of HD.......when they were weaned of Haldol, miracles happened and a lot of those symptoms disappeared.
Per Dr. Dubinksy who used to participate on Hunt Dis (see message below), he has indicated that there are times when Haldol may be the only medication that helps a person with HD after other medications have been tried. There are two or three people on Hunt-Dis/HD Caregiver's who have had success with Haldol when other meds didn't work.
I would guess in 90+% of the families on Hunt-Dis who have had experience with Haldol (prescribed for everything from depression, chorea, ODC, etc.) that there were major improvements once the drug was stopped.
Haldol should never be stopped suddenly but a person needs to be gradually taken off this drug. I would discuss this further with your husband's doctor before allowing your husband to take it.
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Haldol is contraindicated for HD :
Persons with HD (Phds) given Haldol may suffer with accelerated HD.
Lesions of the basal ganglia are common in HD. Contraindications indicate when NOT to prescribe that particular medication. To the list of CNS effects reported to be associated with haloperidol/haldol, add Tardive Dystonia.
Tardive Dystonia is characterized by delayed onset of choreic or dystonicmovements, is often persistent, and has the potential of becoming irreversible. In other words, it can establish a source or cause of choreic movements (manifested later) in addition to HD being a source of choreic movements.
The caudate nucleus is part of the basal ganglia. Lesions of the basal ganglia are not just common in HD, they are essential to a final diagnosis of symptomatic HD. If an autopsy is performed on someone whom everyone is positive died from a complication of advanced HD, and no lesions of the basal ganglia are found at least prior to the days of verification of the HD gene the doctors would conclude it might have been something similar to HD but it was other than HD.
Haloperidol/haldol is contraindicated for use with people who have lesions of the basal ganglia which, by definition, are people who have symptomatic HD
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INFORMATION OF INTEREST TO HD PATIENTS
9/4/97 Dr. Dubinsky wrote: Haloperidol is a non-selective dopamine receptor blocker and can be used safely with sertraline and lorazepam. Decisions about medications are best made between a clinician who is experienced in the treatment of HD and a well informed patient and their well informed family. While there are texts and scientific papers about the treatment of the symptoms of HD, they are not written on stone.
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NEW YORK (MedscapeWire) Jan 03 - A second-generation antipsychotic drug lowers the risk of relapse in patients with schizophrenia by nearly half, according to a team of researchers, led by psychiatrists at Washington University School of Medicine in St. Louis, Missouri. Results of the 2-year, multicenter study are reported in the January 3 issue of the New England Journal of Medicine. This article says, in part:
- Haloperidol and other traditional antipsychotic drugs block activity in brain cells atthe neuron's dopamine receptor. Newer drugs like risperidone block the dopaminereceptor, but they also act at other receptors, such as the serotonin receptor.
- Past studies have shown the newer drugs seem to be more effective and cause feweradverse effects, at least in the short term.
Antipsychotic drugs can have adverse effects on the central nervous system. After years on such drugs, some patients develop symptoms similar to Parkinson's disease. Over many years, some even develop a chronic movement disorder called tardive dyskinesia, a condition
that resembles Huntington's chorea.
The newer drugs, such as risperidone, have fewer neurological adverse effects.
Despite the dramatic change in rates of relapse, Csernansky says more immediate differences observed in study patients were subtle.
"Risperidone had benefits in terms of causing amodest reduction in symptoms and side effects, but it's interesting that those benefits were
relatively small. One wouldn't necessarily notice a large change in symptoms, at least in the short term," he says.
Unfortunately, he says the cost difference between the 2 drugs may influence some clinicians and managed care plans to continue to favor the older drug, but he says the cost of relapse also must be included in the equation.
NOTE:
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The Mental Health site http://www.mentalhealth.com/fr30.html has the most accurate information about drugs than any sites of US origin. It is the best site for trusted information and provides all the research data used in clinical trials. Some commonly prescribed medication for HD are:
Diazepam/T-Quil, Valium
Anxiolytic/Sedative/Muscle Relaxant
