Droperidol versus haloperidol for chemical restraint of agitated and combative patients

Study objective: To compare two related pharmacological agents used for the chemical restraint of agitated and combative patients. Design and setting: A randomized, double-blind, prospective study was carried out in patients requiring physical restraint in a university hospital emergency department. Participants: Sixty-eight violent or agitated adult patients whom the attending physician believed would benefit from chemical restraint to protect the patient and staff and to expedite evaluation. Intervention: Twenty-one participants were administered 5 mg haloperidol IM; 26 were administered 5 mg droperidol IM; 12 were administered haloperidol IV; and nine were administered 5 mg droperidol IV. Results: All patients were rated on a five-point combativeness scale at five, ten, 15, 30, and 60 minutes after the study drug was given. Vital signs also were recorded at these times. IM droperidol decreased combativeness significantly more than IM haloperidol at ten (P = .006), 15 (P = .01), and 30 (P = .04) minutes. There was no significant difference between the two drugs when given by the IV route (β at the 5% confidence level, P = .78). Conclusion: In equal IM doses (5 mg), droperidol results in more rapid control of agitated patients than haloperidol, without any increase in undesirable side effects.