The mental health clinician · 2025
Comparison of droperidol and haloperidol for acute agitation in the emergency department: A retrospective cohort study.
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DiGuglielmo Francesca, D'Amico Melanie, Martine Julianne, Sastic Craig, Vuong Tiffany
Аннотация
INTRODUCTION: To compare the effectiveness of droperidol and haloperidol for acute agitation in the emergency department.
METHODS: Data from electronic health records were collected from January 1, 2022, to August 25, 2023, across 6 emergency departments for patients who received 1 or more doses of either agent within the emergency department. Medical records were included if patients were 18 years of age and older and received at least 1 intramuscular dose of either agent for acute agitation. The primary endpoint was the number of subsequent doses of antipsychotics or benzodiazepines administered within 4 hours of the first dose of either droperidol or haloperidol. Secondary endpoints were the overall proportion of patients requiring subsequent additional doses of antipsychotics or benzodiazepines, the mean initial doses, and the incidence of extrapyramidal symptoms and QTc prolongation.
RESULTS: The results of the independent 2-tailed t-test indicated a mean of 0.75 versus 1.1 additional doses of antipsychotics or benzodiazepines within 4 hours of the initial dose in the droperidol and haloperidol arms, respectively (95% CI = 0.1115, 0.6123, P = 0.0048).
CONCLUSION: Droperidol required a statistically significantly lower number of subsequent doses of antipsychotics or benzodiazepines within 4 hours of the initial dose compared with haloperidol. Droperidol also demonstrated a lower overall proportion of patients requiring any additional doses compared with haloperidol and a lower mean first dose in milligrams. From a safety perspective, there was no documented presence of extrapyramidal symptoms or QTc prolongation with either agent.
METHODS: Data from electronic health records were collected from January 1, 2022, to August 25, 2023, across 6 emergency departments for patients who received 1 or more doses of either agent within the emergency department. Medical records were included if patients were 18 years of age and older and received at least 1 intramuscular dose of either agent for acute agitation. The primary endpoint was the number of subsequent doses of antipsychotics or benzodiazepines administered within 4 hours of the first dose of either droperidol or haloperidol. Secondary endpoints were the overall proportion of patients requiring subsequent additional doses of antipsychotics or benzodiazepines, the mean initial doses, and the incidence of extrapyramidal symptoms and QTc prolongation.
RESULTS: The results of the independent 2-tailed t-test indicated a mean of 0.75 versus 1.1 additional doses of antipsychotics or benzodiazepines within 4 hours of the initial dose in the droperidol and haloperidol arms, respectively (95% CI = 0.1115, 0.6123, P = 0.0048).
CONCLUSION: Droperidol required a statistically significantly lower number of subsequent doses of antipsychotics or benzodiazepines within 4 hours of the initial dose compared with haloperidol. Droperidol also demonstrated a lower overall proportion of patients requiring any additional doses compared with haloperidol and a lower mean first dose in milligrams. From a safety perspective, there was no documented presence of extrapyramidal symptoms or QTc prolongation with either agent.