British Journal of Psychiatry, 185(1), July 2004, pp.63-69.
Publisher:
Cambridge University Press
The pharmacological management of violence in people with psychiatric disorders is under-researched. The authors compare interventions commonly used for controlling agitation or violence in people with serious psychiatric disorders. They randomised 200 people to receive intramuscular lorazepam (4 mg) or intramuscular haloperidol (10 mg) plus promethazine (25–50 mg mix). At blinded assessments 4 h
The pharmacological management of violence in people with psychiatric disorders is under-researched. The authors compare interventions commonly used for controlling agitation or violence in people with serious psychiatric disorders. They randomised 200 people to receive intramuscular lorazepam (4 mg) or intramuscular haloperidol (10 mg) plus promethazine (25–50 mg mix). At blinded assessments 4 h later (99.5% follow-up), equal numbers in both groups (96%) were tranquil or asleep. However, 76% given the haloperidol–promethazine mix were asleep compared with 45% of those allocated lorazepam (RR=2.29,95% CI 1.59–3.39; NNT=3.2,95% CI 2.3–5.4). The haloperidol–promethazine mix produced a faster onset of tranquillisation/sedation and more clinical improvement over the first 2 h. Neither intervention differed significantly in the need for additional intervention or physical restraints, numbers absconding, or adverse effects. Both interventions are effective for controlling violent/agitated behaviour.
Subject terms:
medication, physical restraint, psychiatry, research methods, restraint, compulsory treatment, agitation;