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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Severe Agitation While On Eliquis?

My 90 year old mother-in-law was admitted to the hospital yesterday. She fell and cut her leg and was talking Eliquist (SP?). She became very agitated, verbally requesting to be released, her eyes were bulging and she was stating, There is a conspiracy of why I m here. She has a medium case of dementia due to mini stokes in past years. To calm her down the attending physician prescribed Haldol. I read that older patients with dementia should NOT take Haldol due to the possible risk of death. Should the doctor be prescribing such a risky drug? Is there a less risky drug that could help with her agitation during her stay in the hospital?
Thu, 6 Sep 2018
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Diabetologist,  's  Response
Hi,

First and foremost the symptoms that you have mentioned sound like dementia with hyperactive delirium. Now this can be a difficult condition for patients as well as the medical staff. Because the patients don't realize what they are doing (like asking for premature discharge in your case).

And they tend to pull out the tubes which makes it difficult for the nursing staff as well as the medical staff. There are now many drugs that are available for delirium. However the fastest and the drug with most experience has been Haloperidol. Once the acute delirium settles more new drugs like Quitiapine can be added.

However at first most people suggest Haloperidol. As for the risk, it's known for Haloperidol because as I said the drug has been most extensively used. The effect in elderly of newer drugs is still not completely evaluated.

So yes, given a choice even I would recommend an older drug whose profile is already known rather than a newer drug whose profile is not completely known in a delicate case, which elderly patients usually are. I have tried to make it as simple as possible.

Hope I have answered your query. Let me know if I can assist you further.
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What Causes Severe Agitation While On Eliquis?

Hi, First and foremost the symptoms that you have mentioned sound like dementia with hyperactive delirium. Now this can be a difficult condition for patients as well as the medical staff. Because the patients don t realize what they are doing (like asking for premature discharge in your case). And they tend to pull out the tubes which makes it difficult for the nursing staff as well as the medical staff. There are now many drugs that are available for delirium. However the fastest and the drug with most experience has been Haloperidol. Once the acute delirium settles more new drugs like Quitiapine can be added. However at first most people suggest Haloperidol. As for the risk, it s known for Haloperidol because as I said the drug has been most extensively used. The effect in elderly of newer drugs is still not completely evaluated. So yes, given a choice even I would recommend an older drug whose profile is already known rather than a newer drug whose profile is not completely known in a delicate case, which elderly patients usually are. I have tried to make it as simple as possible. Hope I have answered your query. Let me know if I can assist you further.