Rapid tranquillisation of violent or agitated patients in a psychiatric emergency setting. Pragmatic randomised trial of intramuscular lorazepam v. haloperidol plus promethazine
| Autor: | Jacob Alexander, Prathap Tharyan, Thomas John, Carina Mol, Clive E Adams, Joncy Philip |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.drug_class Sedation Psychological intervention Violence Lorazepam Promethazine law.invention Hypnotic 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine Humans Hypnotics and Sedatives 030212 general & internal medicine Psychiatry Adverse effect Psychomotor Agitation business.industry Mental Disorders 030227 psychiatry Psychiatry and Mental health Anesthesia Sedative Histamine H1 Antagonists Haloperidol Drug Therapy Combination Female medicine.symptom Emergencies business Emergency Service Hospital medicine.drug Antipsychotic Agents |
| Zdroj: | The British journal of psychiatry : the journal of mental science. 185 |
| ISSN: | 0007-1250 |
| Popis: | BackgroundThe pharmacological management of violence in people with psychiatric disorders is under-researched.AimsTo compare interventions commonly used for controlling agitation or violence in people with serious psychiatric disorders.MethodWe randomised 200 people to receive intramuscular lorazepam (4 mg) or intramuscular haloperidol (10 mg) plus promethazine (25–50 mg mix).ResultsAt blinded assessments 4 h later (99.5% follow-up), equal numbers in both groups (96%) were tranquil or asleep. However, 76% given the haloperidol-promethazine mix were asleep compared with 45% of those allocated lorazepam (RR=2.29, 95% CI 1.59–3.39; NNT=3.2, 95% CI 2.3–5.4). The haloperidol-promethazine mix produced a faster onset of tranquillisation/sedation and more clinical improvement over the first 2 h. Neither intervention differed significantly in the need for additional intervention or physical restraints, numbers absconding, or adverse effects.ConclusionsBoth interventions are effective for controlling violent/agitated behaviour. If speed of sedation is required, the haloperidol-promethazine combination has advantages over lorazepam. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|