{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T10:44:14Z","timestamp":1781001854103,"version":"3.54.1"},"reference-count":26,"publisher":"Royal College of Psychiatrists","issue":"1","license":[{"start":{"date-parts":[[2018,1,2]],"date-time":"2018-01-02T00:00:00Z","timestamp":1514851200000},"content-version":"unspecified","delay-in-days":4933,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2004,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The pharmacological management of violence in people with psychiatric disorders is under-researched.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To compare interventions commonly used for controlling agitation or violence in people with serious psychiatric disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We randomised 200 people to receive intramuscular lorazepam (4 mg) or intramuscular haloperidol (10 mg) plus promethazine (25\u201350 mg mix).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At blinded assessments 4 h later (99.5% follow-up), equal numbers in both groups (96%) were tranquil or asleep. However, 76% given the haloperidol-promethazine mix were asleep compared with 45% of those allocated lorazepam (RR=2.29, 95% CI 1.59\u20133.39; NNT=3.2, 95% CI 2.3\u20135.4). The haloperidol-promethazine mix produced a faster onset of tranquillisation\/sedation and more clinical improvement over the first 2 h. Neither intervention differed significantly in the need for additional intervention or physical restraints, numbers absconding, or adverse effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both interventions are effective for controlling violent\/agitated behaviour. If speed of sedation is required, the haloperidol-promethazine combination has advantages over lorazepam.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjp.185.1.63","type":"journal-article","created":{"date-parts":[[2004,6,30]],"date-time":"2004-06-30T21:58:06Z","timestamp":1088632686000},"page":"63-69","source":"Crossref","is-referenced-by-count":148,"title":["Rapid tranquillisation of violent or agitated patients in a psychiatric emergency setting"],"prefix":"10.1192","volume":"185","author":[{"given":"Jacob","family":"Alexander","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prathap","family":"Tharyan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clive","family":"Adams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"John","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carina","family":"Mol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joncy","family":"Philip","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2018,1,2]]},"reference":[{"key":"S0007125000164803_ref26","volume-title":"The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines","year":"1992"},{"key":"S0007125000164803_ref25","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.319.7210.623"},{"key":"S0007125000164803_ref22","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1176\/ajp.139.2.212","article-title":"Assaultive behavior among chronic inpatients","volume":"139","author":"Tardif","year":"1982","journal-title":"American Journal of Psychiatry"},{"key":"S0007125000164803_ref21","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1970.tb02066.x"},{"key":"S0007125000164803_ref17","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.160.6.831"},{"key":"S0007125000164803_ref13","doi-asserted-by":"crossref","first-page":"II","DOI":"10.1186\/1471-244X-2-11","article-title":"TREC-Rio trial: a randomised controlled trial for rapid tranquillisation for agitated patients in emergency psychiatric rooms [ISRCTN44153243]","volume":"2","author":"Huf","year":"2002b","journal-title":"BMC Psychiatry"},{"key":"S0007125000164803_ref12","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-2-4"},{"key":"S0007125000164803_ref11","volume-title":"ECDEU Assessment Manual for Psychopharmacology","author":"Guy","year":"1976"},{"key":"S0007125000164803_ref10","volume-title":"Cochrane Library","author":"Fenton","year":"2003"},{"key":"S0007125000164803_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/S0920-9964(99)00226-1"},{"key":"S0007125000164803_ref6","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v61n1208"},{"key":"S0007125000164803_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-6757(97)90119-4"},{"key":"S0007125000164803_ref3","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.154.5.672"},{"key":"S0007125000164803_ref2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.317.7168.1309"},{"key":"S0007125000164803_ref5","doi-asserted-by":"publisher","DOI":"10.1176\/ps.50.12.1553"},{"key":"S0007125000164803_ref14","first-page":"22","article-title":"The efficacy of a rapid-acting intramuscular formulation of olanzepine for positive symptoms","volume":"62","author":"Jones","year":"2001","journal-title":"Journal of Clinical Psychiatry"},{"key":"S0007125000164803_ref24","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7417.708"},{"key":"S0007125000164803_ref20","first-page":"177","article-title":"Parenteral lorazepam versus parenteral haloperidol for the control of psychotic disruptive behavior","volume":"52","author":"Salzman","year":"1991","journal-title":"Journal of Clinical Psychiatry"},{"key":"S0007125000164803_ref18","first-page":"149","article-title":"Prevalence of mental and behavioural disorders in India: a metaanalysis","volume":"40","author":"Reddy","year":"1998","journal-title":"Indian Journal of Psychiatry"},{"key":"S0007125000164803_ref16","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.180.6.485"},{"key":"S0007125000164803_ref15","volume-title":"Cochrane Library","author":"Joy","year":"2003"},{"key":"S0007125000164803_ref23","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1176\/ajp.142.8.960","article-title":"Assaultive behavior among psychiatric outpatients","volume":"142","author":"Tardiff","year":"1985","journal-title":"American Journal of Psychiatry"},{"key":"S0007125000164803_ref1","first-page":"11","article-title":"Managing the agitated psychotic patient: a reappraisal of the evidence","volume":"61","author":"Allen","year":"2002","journal-title":"journal of Clinical Psychiatry"},{"key":"S0007125000164803_ref9","first-page":"3","article-title":"Treatment of schizophrenia 1999. 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