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Haloperidol and QTc Prolongation in Adults With Psychiatric or Behavioral Indications: A Systematic Review and
Joan Utria Castro1, Mary Cielo Arias Asprilla2, Carlos Alberto Corona-Arias3
1Asociación de Psiquiatras de Argentina, Buenos Aires, Argentina.
Revista Brasileira De Psiquiatria (Sao Paulo, Brazil : 1999)
|June 26, 2026
Summary
Haloperidol did not significantly increase QTc prolongation in placebo-controlled trials. While evidence for QTc ≥500 ms is limited, clinically relevant proarrhythmic events were rare with haloperidol use.
Area of Science:
- Pharmacology
- Cardiology
- Psychiatry
Background:
- Haloperidol is a common antipsychotic for agitation, psychosis, and delirium.
- Concerns exist regarding haloperidol's potential for QTc prolongation and ventricular arrhythmias.
Purpose of the Study:
- To evaluate the association between haloperidol and QTc prolongation in adults.
- To summarize clinically relevant proarrhythmic events associated with haloperidol.
Main Methods:
- Systematic review of randomized controlled trials and comparative observational studies.
- Included adults receiving haloperidol versus placebo, no antipsychotic, or another antipsychotic.
- Primary outcome: QTc prolongation; sensitivity analysis for QTc ≥500 ms.
Main Results:
- Haloperidol was not clearly associated with QTc prolongation by author-defined thresholds in 3 RCTs (OR=1.18, 95%CI 0.83-1.69).
- Evidence for QTc ≥500 ms was imprecise due to limited studies and low event frequency (OR=1.00, 95%CI 0.38-2.65).
- Clinically relevant proarrhythmic events were infrequent and inconsistently reported, precluding quantitative synthesis.
Conclusions:
- In intensive care placebo-controlled trials, haloperidol did not increase QTc prolongation by author-defined criteria.
- Limited and imprecise evidence exists for QTc ≥500 ms.
- Clinically relevant proarrhythmic events were rare and inconsistently reported.
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