Rapid tranquillisation in a psychiatric emergency hospital in Lebanon: TREC-Lebanon – a pragmatic randomised controlled trial of intramuscular haloperidol and promethazine v. intramuscular haloperidol, promethazine and chlorpromazine
| Autor: | Georges Haddad, Maria Elias Nasr, Clive E Adams, Joseph E. Dib, Marc Mourad, Marouan Zoghbi, Myriam Akkari, Werner Henry Ikdais, Francois Kazour, Chadia Haddad, Fouad Tahan, Souheil Hallit, Jean Ajaltouni, Jocelyn Azar, Tony Jean Merheb, Elie Atallah, Dory Hachem, Hiba Yaacoub |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
business.industry Promethazine law.invention 03 medical and health sciences Psychiatry and Mental health 0302 clinical medicine Pharmacotherapy Randomized controlled trial law Relative risk medicine Haloperidol Psychiatric hospital 030212 general & internal medicine Psychiatry business Adverse effect Chlorpromazine 030217 neurology & neurosurgery Applied Psychology medicine.drug |
| Zdroj: | Psychological Medicine. 52:2751-2759 |
| ISSN: | 1469-8978 0033-2917 |
| DOI: | 10.1017/s0033291720004869 |
| Popis: | BackgroundAgitated patients constitute 10% of all emergency psychiatric treatment. Management guidelines, the preferred treatment of clinicians differ in opinion and practice. In Lebanon, the use of the triple therapy haloperidol plus promethazine plus chlorpromazine (HPC) is frequently used but no studies involving this combination exists.MethodA pragmatic randomised open trial (September 2018–July 2019) in the Lebanese Psychiatric Hospital of the Cross in Beirut Lebanon involving 100 people requiring urgent intramuscular sedation due to aggressive behaviour were given intramuscular chlorpromazine 100 mg plus haloperidol 5 mg plus promethazine 25 mg (HPC) or intramuscular haloperidol 5 mg plus promethazine 25 mgResultsPrimary outcome data were available for 94 (94%) people. People allocated to the haloperidol plus promethazine (HP) group showed no clear difference at 20 min compared with patients allocated to the HPC group [relative risk (RR) 0.84, 95% confidence interval (CI) 0.47–1.50].ConclusionsNeither intervention consistently impacted the outcome of ‘calm’, or ‘asleep’ and had no discernible effect on the use of restraints, use of additional drugs or recurrence. If clinicians are faced with uncertainty on which of the two intervention combinations to use, the simpler HP is much more widely tested and the addition of chlorpromazine adds no clear benefit with a risk of additional adverse effects. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|