This review suggests that both benzodiazepines work , but that midazolam has a faster onset and thereby reduces the risk of exposure to violence .
Most evidence , however , exists for the haloperidol plus promethazine mix , with currently more than 400 people r and omised to the combination .
The onset of action is swift and faster than lorazepam .
The combination also seems safe with no clear longer term consequences .
BACKGROUND Health services often manage agitated or violent people and for emergency psychiatric services such behaviour is particularly prevalent ( 10 % ) .
The drugs used in this situation should ensure that the person swiftly and safely becomes calm .
OBJECTIVES To examine whether haloperidol plus promethazine is an effective treatment for psychosis induced agitation/aggression .
Antipsychotic efficacy of the antidepressant trimipramine: a randomized, double-blind comparison with the phenothiazine perazine.
BACKGROUND The tricyclic antidepressant trimipramine exhibits several features ( e. g. , dopaminergic effect , molecular structure similar to a neuroleptic , receptor-binding profile similar to clozapine ) that suggest its potential as an antipsychotic medication . The aim of the study was to investigate the antipsychotic potential of trimipramine in a controlled clinical trial comparing its antipsychotic efficacy with that of a neuroleptic . METHOD In a German multi-center , r and omized , double-blind trial , the antipsychotic efficacy of trimipramine was compared with that of the phenothiazine neuroleptic perazine , using the Brief Psychiatric Rating Scale ( BPRS ) , the Positive and Negative Syndrome Scale ( PANSS ) , and Clinical Global Impressions ( CGI ) . Antidepressant efficacy of both agents was measured by use of the Bech-Rafaelsen Melancholia Scale ( BRMES ) .  Ninety-five patients with acute schizophrenia ( DSM-III-R ) and a BPRS total score > 40 at baseline were treated with either 300 - 400 mg trimipramine or 450 - 600 mg perazine for 5 weeks . RESULTS Therapeutic equivalence of both treatments ( in the dosages used ) could not be demonstrated ( change in BPRS total score , per- protocol [ PP ] analysis , one-sided equivalence testing ) . However , intention-to-treat ( ITT ) as well as PP analysis showed a statistically significant decrease in the BPRS total scores in both treatment groups ( PP : trimipramine , 56.5 + /- 9.8 to 44.1 + /- 17.9 ; perazine , 56.4 + /- 10.8 to 37.9 + /- 12.9 ) . Significant decreases in all BPRS and PANSS subscores as well as CGI results and response rate support the antipsychotic efficacy of trimipramine . The BRMES total scores significantly decreased in both treatment groups without showing a significant difference between the two agents . Trimipramine was better tolerated than perazine and did not elicit extrapyramidal symptoms . CONCLUSION Trimipramine failed to exhibit therapeutic equivalence to perazine in the dosages used . However , there was evidence of a substantial antipsychotic effect of trimipramine . It may be a useful medication if depressive symptoms in psychotic patients require antidepressant treatment or if other antipsychotics can not be administered
This review suggests that both benzodiazepines work , but that midazolam has a faster onset and thereby reduces the risk of exposure to violence .
Most evidence , however , exists for the haloperidol plus promethazine mix , with currently more than 400 people r and omised to the combination .
The onset of action is swift and faster than lorazepam .
The combination also seems safe with no clear longer term consequences .
BACKGROUND Health services often manage agitated or violent people and for emergency psychiatric services such behaviour is particularly prevalent ( 10 % ) .
The drugs used in this situation should ensure that the person swiftly and safely becomes calm .
OBJECTIVES To examine whether haloperidol plus promethazine is an effective treatment for psychosis induced agitation/aggression .