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Droperidol for acute psychosis
S Cure1, J Rathbone, S Carpenter
1Sainsbury Library, Said Business School, University of Oxford, Park End Street, Oxford, Oxon, UK, OX1 1HP. sharon.cure@said-business-school.oxford.ac.uk
The Cochrane Database of Systematic Reviews
|October 21, 2004
Summary
Droperidol may help control agitation in acute psychosis, reducing the need for additional medications. However, evidence from randomized trials is limited, and its availability is decreasing.
Area of Science:
- Psychiatry
- Pharmacology
Background:
- Acute psychotic illnesses often present with agitated or violent behavior requiring urgent sedation.
- Droperidol, a butyrophenone neuroleptic, has been utilized for rapid tranquilization in several countries.
Purpose of the Study:
- To evaluate the efficacy of droperidol compared to other treatments for managing disturbed behavior and psychotic symptoms in acute psychosis.
Main Methods:
- A systematic review of randomized controlled trials (RCTs) was conducted, searching multiple databases and contacting trial authors.
- Included RCTs compared droperidol with any other treatment for acute psychotic episodes.
- Data extraction and quality assessment were performed, with exclusion of studies with >50% loss to follow-up.
Main Results:
- Only two relevant RCTs were identified. One small trial showed intravenous droperidol significantly reduced the need for additional medication compared to placebo in the initial minutes.
- Another trial indicated intramuscular droperidol might reduce additional medication needs compared to haloperidol, though not statistically significant.
- Adverse effects were minimally reported, with one case of mild dystonic reaction in the haloperidol group.
Conclusions:
- The use of droperidol in acute psychosis is primarily based on clinical experience due to a lack of robust randomized trial evidence.
- This is an under-researched area, and droperidol's diminishing availability may limit its future use.