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Haloperidol plus promethazine for psychosis induced aggression
G Huf1, J Alexander, M H Allen
1Rua Senador Vergueiro, 87/702 Flamengo, RJ Rio de Janeiro, Brazil. gisele@ensp.fiocruz.br
The Cochrane Database of Systematic Reviews
|January 18, 2005
Summary
Haloperidol plus promethazine effectively calms agitated psychosis patients. This combination is safe and faster than lorazepam, though midazolam offers quicker sedation, reducing violence risk.
Area of Science:
- Psychiatry
- Clinical Pharmacology
- Emergency Medicine
Background:
- Agitation and aggression are common in emergency psychiatric services, occurring in 10% of cases.
- Effective pharmacological interventions are crucial for swift and safe patient calming.
Purpose of the Study:
- To evaluate the efficacy of haloperidol plus promethazine for treating agitation and aggression induced by psychosis.
Main Methods:
- A systematic review of randomized clinical trials was conducted using the Cochrane Schizophrenia Group's Register.
- Data from two high-quality studies comparing haloperidol/promethazine with midazolam or lorazepam were analyzed.
Main Results:
- Haloperidol plus promethazine demonstrated effectiveness in tranquilizing patients within 30 minutes in both studies.
- While midazolam was faster, haloperidol/promethazine showed comparable safety profiles, with minimal adverse events like respiratory depression or seizures.
- Few patients required additional medication for agitation, and restraint use was low across groups.
Conclusions:
- Haloperidol plus promethazine is a safe and effective treatment for psychosis-induced agitation, with a swift onset of action.
- While benzodiazepines like midazolam offer faster sedation, concerns exist regarding their respiratory depression risks.
- Evidence supports haloperidol/promethazine, urging policymakers to rely on robust data over conjecture for treatment recommendations.