Author: Jared Scott, MD

Educational Pearls:

• Study from Hennepin County EM studied the efficacy of different drugs for agitation, which included 737 patients
• Most patients in this study were male and *surprise* drunk
• Compared doses of common sedatives with primary outcome of sedation at 15 minutes (all intramuscular)
• • haloperidol 5 mg
  • ziprasidone 20 mg
  • olanzapine 10 mg
  • midazolam 5 mg
  • haloperidol 10 mg with the main outcome of agitation at 15 minutes
• Intramuscular midazolam resulted in the lowest level of agitation at 15 minutes, followed by ziprasidone. There were no differences in adverse effects.

References

Klein LR, Driver BE, Miner JR, Martel ML, Hessel M, Collins JD, Horton GB, Fagerstrom E, Satpathy R, Cole JB. Intramuscular Midazolam, Olanzapine, Ziprasidone, or Haloperidol for Treating Acute Agitation in the Emergency Department. Ann Emerg Med. 2018 Oct;72(4):374-385. doi: 10.1016/j.annemergmed.2018.04.027. Epub 2018 Jun 7. PubMed PMID: 29885904.

Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD