The use of midazolam in acutely agitated psychiatric patients.

Agents currently used for acutely agitated patients such as sodium amytal and haloperidol are disadvantageous because of their adverse effects on the respiratory and extrapyramidal systems. Because of this, a rapid, safe, well-absorbed agent such as midazolam would be useful. This study compares the effectiveness of midazolam, sodium amytal, and haloperidol in agitated schizophrenic patients. Five male patients between 28 and 59 years were randomly assigned to each group. They were administered intramuscularly either 10 mg of haloperidol, 250 mg of sodium amytal, or 5 mg of midazolam. Over a 2-hour period, patients were rated for motor agitation, hostility, auditory hallucinations, and flight of ideas. Both midazolam and sodium amytal were significantly more effective than haloperidol in controlling motor agitation. There were no treatment differences on any other symptom rated. These results indicate that further studies on the use of midazolam to achieve rapid tranquilization would be useful.