Droperidol v. haloperidol for sedation of aggressive behaviour in acute mental health: randomised controlled trial.
BACKGROUND
Agitation and aggression are significant problems in acute psychiatric units. There is little consensus on which drug is most effective and safest for sedation of these patients.


OBJECTIVE
To compare the effectiveness and safety of haloperidol v. droperidol for patients with agitation and aggression.


METHODS
In a masked, randomised controlled trial (ACTRN12611000565943) intramuscular droperidol (10 mg) was compared with intramuscular haloperidol (10 mg) for adult patients with acute behavioural disturbance in a psychiatric intensive care unit. The primary outcome was time to sedation within 120 min. Secondary outcomes were use of additional sedation, adverse events and staff injuries.


RESULTS
From 584 patients, 110 were randomised to haloperidol and 118 to droperidol. Effective sedation occurred in 210 (92%) patients within 120 min. There was no significant difference in median time to sedation: 20 min (interquartile range 15-30, range 10-75) for haloperidol v. 25 min (IQR 15-30, range 10-115) for droperidol (P = 0.89). Additional sedation was used more often with haloperidol (13% v. 5%, P = 0.06), but adverse effects were less common with haloperidol (1% v. 5%, P = 0.12). There were 8 staff injuries.


CONCLUSIONS
Both haloperidol and droperidol were effective for sedation of patients with acute behavioural disturbance.
Leonie Calver, School of Medicine and Public Health, University of Newcastle, New South Wales; Vincent Drinkwater, Rahul Gupta, MBBS, Psychiatric Emergency Service, Hunter New England Mental Health Service, New South Wales; Colin B. Page, MBChB, School of Medicine, University of Queensland, Brisbane; Geoffrey K. Isbister, MD, School of Medicine and Public Health, University of Newcastle, New South Wales, Australia.
Leonie
L
Calver
Leonie Calver, School of Medicine and Public Health, University of Newcastle, New South Wales; Vincent Drinkwater, Rahul Gupta, MBBS, Psychiatric Emergency Service, Hunter New England Mental Health Service, New South Wales; Colin B. Page, MBChB, School of Medicine, University of Queensland, Brisbane; Geoffrey K. Isbister, MD, School of Medicine and Public Health, University of Newcastle, New South Wales, Australia.
Vincent
V
Drinkwater
Leonie Calver, School of Medicine and Public Health, University of Newcastle, New South Wales; Vincent Drinkwater, Rahul Gupta, MBBS, Psychiatric Emergency Service, Hunter New England Mental Health Service, New South Wales; Colin B. Page, MBChB, School of Medicine, University of Queensland, Brisbane; Geoffrey K. Isbister, MD, School of Medicine and Public Health, University of Newcastle, New South Wales, Australia.
Rahul
R
Gupta
Leonie Calver, School of Medicine and Public Health, University of Newcastle, New South Wales; Vincent Drinkwater, Rahul Gupta, MBBS, Psychiatric Emergency Service, Hunter New England Mental Health Service, New South Wales; Colin B. Page, MBChB, School of Medicine, University of Queensland, Brisbane; Geoffrey K. Isbister, MD, School of Medicine and Public Health, University of Newcastle, New South Wales, Australia.
Colin B
CB
Page
Leonie Calver, School of Medicine and Public Health, University of Newcastle, New South Wales; Vincent Drinkwater, Rahul Gupta, MBBS, Psychiatric Emergency Service, Hunter New England Mental Health Service, New South Wales; Colin B. Page, MBChB, School of Medicine, University of Queensland, Brisbane; Geoffrey K. Isbister, MD, School of Medicine and Public Health, University of Newcastle, New South Wales, Australia.
Geoffrey K
GK
Isbister
D000293:Adolescent; D000328:Adult; D000368:Aged; D000374:Aggression / Q000187:drug effects*; D014150:Antipsychotic Agents / Q000627:therapeutic use; D016292:Procedural Sedation / Q000379:methods*; D004329:Droperidol / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006220:Haloperidol / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D060051:Occupational Injuries / Q000517:prevention & control; D011595:Psychomotor Agitation / Q000188:drug therapy*; D013997:Time Factors; D055815:Young Adult
D014150:Antipsychotic Agents; D006220:Haloperidol; D004329:Droperidol