A retrospective analysis of intramuscular haloperidol and intramuscular olanzapine in the treatment of agitation in drug- and alcohol-using patients

General Hospital Psychiatry
Kai MacDonaldDavid Feifel

Abstract

The treatment of agitation in drug- and alcohol-using emergency patients is understudied. We performed a retrospective chart review of 105 agitated emergency department patients who received either intramuscular (IM) haloperidol or IM olanzapine, comparing prescribing patterns, level of agitation, response to treatment and side effects in patients positive for drugs or alcohol [D/A(+)] and patients negative for drugs or alcohol [(D/A(-)]. The haloperidol-benzodiazepine combination was the most frequently prescribed treatment in both groups, although alcohol(+) status biased clinicians toward using haloperidol alone. Overall, D/A(+) and D/A(-) patients responded to the initial intervention at similar rates, although D/A(+) patients were rated as more agitated and had more posttreatment sedation than D/A(-) patients. In D/A(+) patients, haloperidol+benzodiazepine and IM olanzapine performed better than haloperidol alone. There were no serious adverse events with any treatment. Findings support the generalization of efficacy data from more rarified agitated samples to populations with high rates of substance use and highlight the need for prospective, inclusive, randomized trials comparing the commonly used haloperidol-benzodiazep...Continue Reading

References

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Citations

Feb 26, 2014·Medizinische Klinik, Intensivmedizin und Notfallmedizin·A WolfF-G B Pajonk
Jan 1, 2016·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Marc L MartelJon B Cole
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Nov 28, 2020·Current Treatment Options in Oncology·Mellar P Davis, Gareth J Sanger

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