Intramuscular flunitrazepam versus intramuscular haloperidol in the emergency treatment of aggressive psychotic behavior.
OBJECTIVE
The authors examined the efficacy of intramuscular flunitrazepam compared with intramuscular haloperidol for the immediate control of agitated or aggressive behavior in acutely psychotic patients.


METHODS
Twenty-eight actively psychotic inpatients, aged 20-60 years, who were under treatment with neuroleptic agents were selected for the study. Each was randomly assigned on a double-blind basis to receive either 5 mg i.m. of haloperidol (N=13) or 1 mg i.m. of flunitrazepam (N=15) during an aggressive event. Verbal and physical aggression was measured over time with the Overt Aggression Scale. Patients were also rated with the Brief Psychiatric Rating Scale and the Clinical Global Impression scale.


RESULTS
Both flunitrazepam and haloperidol exhibited acute antiaggressive activity. This beneficial effect, as assessed by the Overt Aggression Scale, was obtained within 30 minutes.


CONCLUSIONS
Intramuscular flunitrazepam may serve as a convenient, rapid, safe, and effective adjunct to neuroleptics in reducing aggressive behavior in emergency psychiatric settings.
Dorevitch
A
A
Talbieh Mental Health Center, Hebrew University Faculty of Medicine, Jerusalem, Israel.
Katz
N
N
Zemishlany
Z
Z
Aizenberg
D
D
Weizman
A
A
D000208:Acute Disease; D000328:Adult; D000374:Aggression / Q000187:drug effects* / Q000523:psychology; D014150:Antipsychotic Agents / Q000627:therapeutic use; D010054:Brief Psychiatric Rating Scale / Q000706:statistics & numerical data; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004632:Emergency Medical Services; D005260:Female; D005445:Flunitrazepam / Q000008:administration & dosage* / Q000627:therapeutic use; D006220:Haloperidol / Q000008:administration & dosage* / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D005445:Flunitrazepam; D006220:Haloperidol