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NICE, 2005

NICE, 2005. Psychiatric in-patients setting Onderscheid tussen Psychotic and non-psychotic context Non-psychotic: Lorazepam Psychotic: Lorazepam en Haloperidol. P In need of “rapid tranquillisation” I Haloperidol C Any other medication O Tranquil or a sleep after 20 min. .

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NICE, 2005

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  1. NICE, 2005 • Psychiatric in-patients setting • Onderscheid tussen Psychotic and non-psychotic context • Non-psychotic: Lorazepam • Psychotic: Lorazepam en Haloperidol

  2. P In need of “rapid tranquillisation” I Haloperidol C Any other medication O Tranquil or a sleep after 20 min.

  3. Haloperidol versus Haloperidol plus promethazine (2007) • Haloperidol alone: 29% 5 mg, 71% 10 mg • Haloperidol plus promethazine 50% 5 mg en 50% 10 mg • Haloperidol alone 7% acute side effects.

  4. Haloperidol and promethazine versus lorazepam (2004) • Lorazepam 4 mg. i.m. • Haloperidol 10 mg with 96% 50 mg promethazine and 4% 25 mg promethazine • No dystonia, one patient with lorazepam respiratory difficulty

  5. Haloperidol plus promethazine versus olanzapine (2007) • 148 of 150: 10 mg haloperidol and 50 mg promethazine, 2: 5 mg haloperidol and 25 mg promethazine • 148: 10 mg olanzapine, 2: 5mg • More additional drugs over 4 hours with olanzapine

  6. Conclusions • Haloperidol plus promethazine is far better and safer than haloperidol alone • It has a faster onset compared to lorazepam • Needs fewer medical interventions within four hours than olanzapine

  7. Limitations • Open evaluation of treatment after blind allocation • Evaluation by different raters • Done in India (2) and Brasil (1)

  8. SEH NICE 2005 • Lorazepam als nog geen diagnose en onzekerheid over medische voorgeschiedenis • Als eerder antipsychotica gebruikt: haloperidol met lorazepam

  9. Links EBM calculator: http://www.ebem.org/nntcalculator.html Literatuur beoordelingsformulieren http://www.cbo.nl/thema/Richtlijnen/EBRO-handleiding/G-Literatuurbeoordelings-formulieren/

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