Efficacy and safety of haloperidol-promethazine combination versus chlorpromazine-promethazine in managing acute behavioral disturbances and violent behavior in psychiatric patients.

OBJECTIVE

This study aimed to evaluate the efficacy and safety of pharmacological interventions in managing acute behavioral disturbances and violent behavior among individuals diagnosed with psychiatric disorders.

METHODS

A double-blinded, randomized controlled trial was conducted involving 64 individuals presenting with acute behavioral disturbances or violent behavior. Participants were randomly allocated to either the experimental group (n = 32) or control group (n = 32). The experimental group received an intramuscular injection of haloperidol combined with promethazine, while the control group was administered chlorpromazine combined with promethazine. The efficacy of treatment was assessed using the Positive and Negative Syndrome Scale (PANSS), Impulsive Behavior Scale, Suicide Risk Assessment Scale, and Elopement Risk Scale. Adverse drug reactions were monitored using the Adverse Drug Reaction Scale.

RESULTS

The experimental group demonstrated significantly greater improvement in behavioral symptoms compared to the control group, as indicated by reductions in PANSS and impulsivity scores. Furthermore, the incidence of adverse drug reactions was significantly lower in the experimental group relative to the control group.

CONCLUSION

The combination of haloperidol and promethazine may be more effective and associated with fewer adverse effects compared to chlorpromazine and promethazine in the management of acute behavioral disturbances and violent behavior in individuals with psychiatric disorders. These findings support the use of haloperidol in combination with promethazine as a preferred intervention in acute psychiatric settings.