When someone is in delirium, a sudden, fluctuating state of confusion often caused by infection, medication, or metabolic imbalance. Also known as acute confusional state, it’s not just forgetfulness—it’s a medical emergency that can lead to falls, longer hospital stays, or even death if not treated properly. Loxapine, an older antipsychotic drug originally developed for schizophrenia. Also known as Adasuve when inhaled, it’s now used off-label to calm severe agitation in delirium, especially in older patients who can’t take benzodiazepines. Unlike many newer antipsychotics, loxapine acts fast—sometimes within minutes—making it a go-to when someone is screaming, hitting, or trying to pull out IV lines. It’s not a cure for delirium, but it can buy time to find and fix the real cause: a urinary infection, low sodium, or a reaction to pain meds.
Delirium often shows up in hospitals or nursing homes, especially in seniors with dementia. Doctors avoid sedating them with sleep aids like benzodiazepines because those can make confusion worse. That’s where loxapine fits in. It blocks dopamine receptors in the brain, which quiets the overactive signals causing agitation. But it’s not risk-free. It can cause muscle stiffness, tremors, or even a rare but dangerous condition called neuroleptic malignant syndrome. That’s why it’s usually given in low doses, often as an inhaler, so it hits the lungs and brain fast and doesn’t linger in the body. It’s not for long-term use. It’s for crisis control.
What you won’t find in most hospital protocols is how often loxapine is used alongside non-drug fixes—like reorienting the patient with clocks and family photos, turning down the lights at night, or making sure they’re not dehydrated. Those things matter just as much. But when the chaos is too loud, loxapine gives staff a tool to step in safely. It’s not perfect, but for many families watching a loved one spiral into fear and aggression, it’s the difference between a night of terror and a night of quiet.
Below, you’ll find real-world posts that dig into how drugs like loxapine compare with other antipsychotics, what side effects actually look like in practice, and how doctors decide when to use them—or avoid them altogether. These aren’t theoretical discussions. They’re from people who’ve been there: caregivers, nurses, and patients who’ve seen the highs and lows of treating delirium with medication.
Explore how loxapine can be used to manage delirium symptoms, its dosing options, evidence, side effects, and how it stacks up against other antipsychotics.
