[Droperidol for the treatment of acutely agitated patients: still an option]

Tijdschr Psychiatr. 2013;55(3):183-92.
[Article in Dutch]

Abstract

Background: In Flemish emergency psychiatry droperidol is still an option for the treatment of agitation. However, its efficacy and safety are contested.

Aim: To find out whether the continuing use of droperidol to treat agitation is justified on scientific grounds.

Method: Randomised controlled trials of droperidol (intramuscular or intravenous) were traced via a systematic search of the literature. These data were supplemented with a description of the drug’s most important pharmacological properties and a survey of the literature on cardiac side-effects and of the place accorded to droperidol in some guidelines.

Results: The efficacy and safety of droperidol (IM/IV) were studied in 8 randomised control-led trials: 352 patients treated with droperidol. Droperidol was compared with benzodiazepines, antipsychotics and combination treatment. A single injection of droperidol was successful in 64-92% of patients. Droperidol tended to act faster and be more effective than haloperidol and lorazepam. There were very few side-effects. No clinically important cardiac side-effects were reported; this is also in keeping with evidence revealed in systematic reviews on the subject. The ecological validity of the trials was high.

Conclusion: In spite of a decline in the popularity of droperidol in most guidelines, the drug still seems to play a valuable role in the treatment of the agitated patient. Because it acts rapidly over a short period of time and is safe to use in patients with high (co)morbidity, it is still in favour with many health professionals.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Acute Disease
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / therapeutic use*
  • Droperidol / adverse effects
  • Droperidol / therapeutic use*
  • Humans
  • Psychotic Disorders / drug therapy*
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

Substances

  • Antipsychotic Agents
  • Droperidol