Midazolam sedates agitated patients more rapidly than haloperidol-promethazine

TREC Collaborative Group. Rapid tranquillisation for agitated patients in emergency psychiatric rooms: a randomised trial of midazolam versus haloperidol plus promethazine. BMJ 2003;327:708–13. [OpenUrl][1][Abstract/FREE Full Text][2] Q Is midazolam or haloperidol plus promethazine more effective for rapid sedation of agitated or aggressive people with mental illness? ### ![Graphic][3] Design: Randomised controlled trial. ### ![Graphic][4] Allocation: Concealed. ### ![Graphic][5] Blinding: Treatment was open, but assessors were blinded to intervention. ### ![Graphic][6] Follow up period: Twenty minutes for primary outcome. ### ![Graphic][7] Setting: Three psychiatric emergency rooms, Rio de Janeiro, Brazil. ### ![Graphic][8] Patients: 301 people needing sedation for agitation or aggressive behaviour. ### ![Graphic][9] Intervention: Intramuscular injection of midazolam (15 mg or 7.5 mg) or haloperidol plus promethazine (5 mg or 10 mg haloperidol plus 50 mg promethazine). ### ![Graphic][10] Outcomes: Participant asleep or tranquillised at 20 minutes; adverse effects. ### ![Graphic][11] Patient follow up: 99%. Midazolam rendered significantly more participants asleep or tranquil in 20 minutes than haloperidol plus promethazine (AR … [1]: {openurl}?query=rft.jtitle%253DBMJ%26rft.stitle%253DBMJ%26rft.issn%253D0007-1447%26rft.volume%253D327%26rft.issue%253D7417%26rft.spage%253D708%26rft.epage%253D713%26rft.atitle%253DRapid%2Btranquillisation%2Bfor%2Bagitated%2Bpatients%2Bin%2Bemergency%2Bpsychiatric%2Brooms%253A%2Ba%2Brandomised%2Btrial%2Bof%2Bmidazolam%2Bversus%2Bhaloperidol%2Bplus%2Bpromethazine%26rft_id%253Dinfo%253Adoi%252F10.1136%252Fbmj.327.7417.708%26rft_id%253Dinfo%253Apmid%252F14512476%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=bmj&resid=327/7417/708&atom=%2Febmental%2F7%2F2%2F42.atom [3]: /embed/inline-graphic-1.gif [4]: /embed/inline-graphic-2.gif [5]: /embed/inline-graphic-3.gif [6]: /embed/inline-graphic-4.gif [7]: /embed/inline-graphic-5.gif [8]: /embed/inline-graphic-6.gif [9]: /embed/inline-graphic-7.gif [10]: /embed/inline-graphic-8.gif [11]: /embed/inline-graphic-9.gif