Moderate
Alprazolam × Haloperidol
Benzodiazepines. Short-to-medium-acting anxiolytics×First-generation antipsychotics. Butyrophenone derivatives
Mechanism
Additive CNS depression and sedation. In older patients: high delirium and fall risk.
Symptoms
Deep sedation, drowsiness, ataxia, confusion (especially in older patients). Orthostatic hypotension possible (haloperidol blocks α1-adrenoceptors).
Management
The combination is used briefly in acute agitation or psychotic episodes. In older patients: lorazepam at minimum dose with olanzapine or aripiprazole (less α1-blockade than haloperidol) is preferable.