Haloperidol is, by far, the best-studied antipsychotic in ICU, appears to be safe in the dosing range used in these two trials and is easy to administer and titrate.

For these reasons, if a clinician chooses to pharmacologically treat a delirious adult ICU patient, haloperidol is better supported by evidence than other antipsychotics, which have not been carefully studied and are frequently inappropriately continued after hospital discharge.

Importantly, the recommended nonpharmacologic interventions should be implemented in these patients.

A Bayesian analysis of MIND-USA and examinations of long-term outcomes of the AID-ICU trial including 1-year mortality, health-related quality of life and cognitive measures along with future trials examining the effect of haloperidol on agitation and delirium severity will add important information to guide clinical decisions.

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