title: Efficacy and Safety of Levosulpiride Versus Haloperidol Injection in Patients With Acute Psychosis: A Randomized Double-Blind Study.
abstract: BACKGROUND
  Injectable antipsychotics are frequently required for controlling agitation and aggression in acute psychosis. No study has examined the use of injectable levosulpiride for this indication.
  
  
  OBJECTIVE
  To compare the efficacy and safety of injectable levosulpiride and haloperidol in patients with acute psychosis.
  
  
  METHODS
  This was a randomized, double-blind, parallel-group study in which 60 drug-naive patients having acute psychosis were randomly assigned to receive either intramuscular haloperidol (10-20 mg/d) or levosulpiride (25-50 mg/d) for 5 days. All patients were rated on Brief Psychiatric Rating Scale (BPRS), Overt Agitation Severity Scale (OASS), Overt Aggression Scale-Modified (OAS-M) scores, Simpson Angus Scale (SAS), and Barnes Akathisia Rating Scale (BARS).
  
  
  RESULTS
  Repeated-measures ANOVA for BPRS scores showed significant effect of time (P < 0.001) and a trend toward greater reduction in scores in haloperidol group as shown by group × time interaction (P = 0.076). Repeated-measures ANOVA for OASS showed significant effect of time (P < 0.001) but no group × time interaction. Repeated-measures ANOVA for OAS-M scores showed significant effect of time (P < 0.001) and greater reduction in scores in haloperidol group as shown by group × time interaction (P = 0.032). Lorazepam requirement was much lower in haloperidol group as compared with those receiving levosulpiride (P = 0.022). Higher rates of akathisia and extrapyramidal symptoms were noted in the haloperidol group.
  
  
  CONCLUSIONS
  Haloperidol was more effective than levosulpiride injection for psychotic symptoms, aggression, and severity of agitation in acute psychosis, but extrapyramidal adverse effects were less frequent with levosulpiride as compared with those receiving haloperidol.
authors.affiliation: From the *Department of Psychiatry, Sarojini Naidu Medical College, Agra; the †Department of Psychiatry, Kasturba Medical College, Manipal, Karnataka, India; the ‡Lead Consultant Psychiatrist in Intellectual Disabilities, Surrey and Borders NHS Foundation Trust, Leatherhead, UK; and the §Department of Psychiatry, Baba Raghav Das Medical College, Gorakhpur, India.
authors.forename: Sagar
authors.initials: S
authors.lastname: Lavania
authors.forename: Samir Kumar
authors.initials: SK
authors.lastname: Praharaj
authors.forename: Hariender Singh
authors.initials: HS
authors.lastname: Bains
authors.forename: Vishal
authors.initials: V
authors.lastname: Sinha
authors.forename: Abhinav
authors.initials: A
authors.lastname: Kumar
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006220:Haloperidol / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000188:drug therapy*; D013469:Sulpiride / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D013469:Sulpiride; D006220:Haloperidol; C078143:levosulpiride