The comparative efficacy of Haloperidol (IM) plus Lorazepam (PO) and Risperidon plus Lorazepam in the management of acute agitation

Abstract

High prevalence of acute psychotic agitation in psychiatric emergency centers, necessitates finding an medication with less side effects and more efficacy. Concerning the reports about the efficacy of atypical antipsychotics (Even in oral route) in such cases. We decided to examine the efficacy of these drugs in comparison with older ones (Oral Risperidon plus Lorazepam and Haloperidol (IM) plus Lorazepams. The sample population included 60 acute psychotic agitated patients admitted to emergency room of Ebne-Sina psychiatric center. The exclusion criteria were seizure disorder-pregnancy-substance abuse, developmental disorders and other major medical problems. These patients were randomly divided in two groups. The first group was given Haloperidol (5 mg/IM) plus Lorazepam (2 mg/PO) and in the second group, Risperidon (2 mg/PO) plus Lorazepam (2 mg/PO) were administered remission was assessed based on the total score and scores of subclasses of PANSS including: Hostility, incooperativeness hallucinatory behaviors, impulse dyscontrol and excitement on time zero, 30 and 60 minutes. The results were analyzed using the proper test analyzer. Significant decrease in PANSS scores were observed in each group (P<0.001). There was no significant differences in total score and scores of subclasses between 2 groups. 3 patients of each group needed additional dose 1 hour after the first one. The mean time to induce sleep in Haloperidol group was 60 minutes (SD: 33 m) and in the Risperidon group 55 minutes (SD: 34 m). The present study similar to previous ones showed that the efficacy Risperidon plus Lorazepam (PO) in the control psychotic agitation was equal to that of intramuscular Haloperidol plus oral Lorazepam.

Keywords

• Psychotic agitation
• Atypical antipsychotics
• Risperidon
• PANSS