Tranquilising agitated mentally ill patients: intramuscular haloperidol plus promethazine reduces need for additional medication or medical attention compared to olanzapine.

摘要

Question: intramuscular haloperidol plus promethazine or intramuscular olanzapine: which is more effective for the emergency treatment of agitated and violent adults with mental illness?Patients: 300 hospitalised adults with mental illness (ICD-10 classified), presenting with aggressive or violent behaviour. Inclusions: consecutive patients in the psychiatric unit for whom intramuscular sedation was indicated and where intervention did not put the patient at risk. Setting: Psychiatric unit of the Christian Medical College, Vellore, South India; September 2005 to July 2006. Intervention: Single intramuscular injection of haloperdiol (10 mg) plus promethazine (50 mg), or olanzapine (10 mg). Two patients in each group (1%) received half of the recommend doses.Outcomes: Primary outcome: proportion of patients tranquil (calm and non-agitated with no dangerous behaviour) or asleep (not awoken by ambient disturbances) at 15 and 240 min. Secondary outcomes: proportion requiring further medical attention; need for other medical interventions; adverse events.