Droperidol v. Haloperidol for Sedation of Aggressive Behaviour in Acute Mental Health: Randomised Controlled Trial

Br J Psychiatry. 2015 Mar;206(3):223-8. doi: 10.1192/bjp.bp.114.150227. Epub 2014 Nov 13.

Abstract

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.

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

Method: 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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aggression / drug effects*
  • Antipsychotic Agents / therapeutic use
  • Conscious Sedation / methods*
  • Droperidol / adverse effects
  • Droperidol / therapeutic use*
  • Female
  • Haloperidol / adverse effects
  • Haloperidol / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Occupational Injuries / prevention & control
  • Psychomotor Agitation / drug therapy*
  • Time Factors
  • Young Adult

Substances

  • Antipsychotic Agents
  • Haloperidol
  • Droperidol