Haloperidol Plus Conventional Tx Effective for Symptomatic Gastroparesis

Future research, with larger sample sizes, is needed to evaluate the external validity of the findings
Future research, with larger sample sizes, is needed to evaluate the external validity of the findings

A study published in Academic Emergency Medicine suggests that haloperidol may be an effective first-line agent in combination with standard analgesic and antiemetic therapy for the treatment of gastroparesis in the emergency department.

Researchers from The University of Texas MD Anderson Cancer Center, in Houston, TX, conducted a randomized, double-blind, placebo-controlled trial to assess whether haloperidol added to conventional therapy would improve symptoms in patients with gastroparesis presenting to the emergency department. 

The study included 33 adult patients presenting to the emergency department with acute exacerbation of previously diagnosed gastroparesis; these patients were assigned to haloperidol 5mg plus conventional therapy (n=15) or placebo plus conventional therapy (n=18). Study authors documented the severity of each patient's abdominal pain (10-point scale) and nausea (5-point scale) prior to therapy and every 15 minutes thereafter for 1 hour. The primary outcome was the change in intensity of abdominal pain and nausea 1 hour post-administration of the study drug. 

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At baseline, mean intensity of pain was 8.5 in the haloperidol group and 8.28 in the placebo group. The mean pretreatment nausea scores were 4.53 in the haloperidol group and 4.11 in the placebo group. Results showed 1 hour after treatment, mean pain and nausea scores decreased to 3.13 and 1.83 in the haloperidol group vs. 7.17 and 3.39 in the placebo group. 

The decrease in mean pain intensity for the haloperidol group was 5.37 (P≤0.001) vs. 1.11 in the placebo group (P=0.11). For nausea, there was a mean reduction of 2.70 (P≤0.001) for the haloperidol group vs. 0.72 (P=0.05) in the placebo group. "Therefore, the reductions in symptom scores were statistically significant in the haloperidol group but not in the placebo group," noted lead author, Carlos J. Roldan, MD. There were no adverse events reported in the study.

The authors stated that future studies with "larger sample sizes and better control over concomitant therapy are needed to confirm the effectiveness and safety of haloperidol for the treatment of intractable nausea and abdominal pain."

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