{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:07:53Z","timestamp":1759450073883,"version":"build-2065373602"},"reference-count":11,"publisher":"American Association of Psychiatric Pharmacists (AAPP)","issue":"5","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec>\n<jats:title>Introduction<\/jats:title>\n<jats:p>To compare the effectiveness of droperidol and haloperidol for acute agitation in the emergency department.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Data from electronic health records were collected from January 1, 2022, to August 25, 2023, across 6 emergency departments for patients who received 1 or more doses of either agent within the emergency department. Medical records were included if patients were 18 years of age and older and received at least 1 intramuscular dose of either agent for acute agitation. The primary endpoint was the number of subsequent doses of antipsychotics or benzodiazepines administered within 4 hours of the first dose of either droperidol or haloperidol. Secondary endpoints were the overall proportion of patients requiring subsequent additional doses of antipsychotics or benzodiazepines, the mean initial doses, and the incidence of extrapyramidal symptoms and QTc prolongation.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The results of the independent 2-tailed <jats:italic>t<\/jats:italic>-test indicated a mean of 0.75 versus 1.1 additional doses of antipsychotics or benzodiazepines within 4 hours of the initial dose in the droperidol and haloperidol arms, respectively (95% CI = 0.1115, 0.6123, <jats:italic>P<\/jats:italic> = 0.0048).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Droperidol required a statistically significantly lower number of subsequent doses of antipsychotics or benzodiazepines within 4 hours of the initial dose compared with haloperidol. Droperidol also demonstrated a lower overall proportion of patients requiring any additional doses compared with haloperidol and a lower mean first dose in milligrams. From a safety perspective, there was no documented presence of extrapyramidal symptoms or QTc prolongation with either agent.<\/jats:p>\n<\/jats:sec>","DOI":"10.9740\/mhc.2025.10.232","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T12:33:27Z","timestamp":1759322007000},"page":"232-236","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of droperidol and haloperidol for acute agitation in the emergency department: A retrospective cohort study"],"prefix":"10.9740","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9175-4881","authenticated-orcid":true,"given":"Francesca","family":"DiGuglielmo","sequence":"first","affiliation":[{"name":"(Corresponding author) Clinical Pharmacist, Inspira Medical Center, Vineland, New Jersey, diguglielmof1@ihn.org"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2174-9176","authenticated-orcid":true,"given":"Melanie","family":"D\u2019Amico","sequence":"additional","affiliation":[{"name":"Clinical Pharmacist, Inspira Medical Center, Vineland, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8662-8385","authenticated-orcid":true,"given":"Julianne","family":"Martine","sequence":"additional","affiliation":[{"name":"Clinical Pharmacist, Inspira Medical Center, Vineland, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4295-637X","authenticated-orcid":true,"given":"Craig","family":"Sastic","sequence":"additional","affiliation":[{"name":"Clinical Pharmacist, Inspira Medical Center, Vineland, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6026-4188","authenticated-orcid":true,"given":"Tiffany","family":"Vuong","sequence":"additional","affiliation":[{"name":"Clinical Pharmacist, Inspira Medical Center, Vineland, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4719","reference":[{"issue":"4","key":"i2168-9709-15-5-232-b01","series-title":"Adv Emerg Nurs J","first-page":"306","article-title":"Management of acute agitation in the emergency department","volume":"34","author":"Baker","year":"2012","unstructured":"Baker SN. Management of acute agitation in the emergency department. Adv Emerg Nurs J. 2012;34(4):306-18; quiz 319-20. DOI: 10.1097\/TME.0b013e31826f12d6"},{"series-title":"Droperidol for Agitation in Acute Care [Internet]","author":"Edge","key":"i2168-9709-15-5-232-b02","unstructured":"Edge R,\nArg\u00e1ez C. Droperidol for Agitation in Acute Care [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health. PMID: 34185452"},{"key":"i2168-9709-15-5-232-b03","article-title":"Emergency Department Violence Report","author":"American College of Emergency Physicians [Internet].","year":"2022","unstructured":"American College of Emergency Physicians [Internet]. Emergency Department Violence Report 2022: Abridged; 2022 Aug [cited 2023 Aug]. Available from: https:\/\/www.emergencyphysicians.org\/siteassets\/emphysicians\/all-pdfs\/acep-emergency-department-violence-report-2022-abridged.pdf"},{"issue":"3","key":"i2168-9709-15-5-232-b04","series-title":"Psychiatr Clin North Am","first-page":"701","article-title":"Management of the acutely violent patient","volume":"28","author":"Petit","year":"2005","unstructured":"Petit JR. Management of the acutely violent patient. Psychiatr Clin North Am. 2005;28(3):701-11. DOI: 10.1016\/j.psc.2005.05.011"},{"article-title":"National Library of Medicine (US)","author":"DailyMed [Internet]","key":"i2168-9709-15-5-232-b05","unstructured":"DailyMed [Internet]. National Library of Medicine (US) [updated 2023 Mar; cited 2023 Aug 28]. American Regent, Inc. DROPERIDOL injection. Available from: https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=147e033d-d997-4ef6-8bb5-a9ba372590b2"},{"issue":"6","key":"i2168-9709-15-5-232-b06","series-title":"Clin Pharmacokinet","first-page":"435","article-title":"Pharmacokinetics of haloperidol: an update","volume":"37","author":"Kudo","year":"1999","unstructured":"Kudo S,\nIshizaki T. Pharmacokinetics of haloperidol: an update. Clin Pharmacokinet. 1999;37(6):435-56. DOI: 10.2165\/00003088-199937060-00001"},{"issue":"7","key":"i2168-9709-15-5-232-b07","series-title":"Acad Emerg Med","first-page":"744","article-title":"A prospective, double-blind, randomized trial of midazolam versus haloperidol versus lorazepam in the chemical restraint of violent and severely agitated patients","volume":"11","author":"Nobay","year":"2004","unstructured":"Nobay F,\nSimon BC,\nLevitt MA,\nDresden GM. A prospective, double-blind, randomized trial of midazolam versus haloperidol versus lorazepam in the chemical restraint of violent and severely agitated patients. Acad Emerg Med. 2004;11(7):744-9. DOI: 10.1197\/j.aem.2003.06.015"},{"issue":"3","key":"i2168-9709-15-5-232-b08","series-title":"Prehosp Emerg Care","first-page":"375","article-title":"Comparison of droperidol and haloperidol for use by paramedics: assessment of safety and effectiveness","volume":"18","author":"Macht","year":"2014","unstructured":"Macht M,\nMull AC,\nMcVaney KE,\nCaruso EH,\nJohnston JB,\nGaither JB, et al. Comparison of droperidol and haloperidol for use by paramedics: assessment of safety and effectiveness. Prehosp Emerg Care. 2014;18(3):375-80. DOI: 10.3109\/10903127.2013.864353"},{"issue":"3","key":"i2168-9709-15-5-232-b09","series-title":"Ann Emerg Med","first-page":"230","article-title":"The safety and effectiveness of droperidol for sedation of acute behavioral disturbance in the emergency department","volume":"66","author":"Calver","year":"2015","unstructured":"Calver L,\nPage CB,\nDownes MA,\nChan B,\nKinnear F,\nWheatley L, et al. The safety and effectiveness of droperidol for sedation of acute behavioral disturbance in the emergency department. Ann Emerg Med. 2015;66(3):230-8.e1. DOI: 10.1016\/j.annemergmed.2015.03.016"},{"issue":"1","key":"i2168-9709-15-5-232-b10","series-title":"Tzu Chi Med J","first-page":"1","article-title":"Evidence-based review and appraisal of the use of droperidol in the emergency department","volume":"30","author":"Lai","year":"2018","unstructured":"Lai PC,\nHuang YT. Evidence-based review and appraisal of the use of droperidol in the emergency department. Tzu Chi Med J. 2018;30(1):1-4. DOI: 10.4103\/tcmj.tcmj_195_17"},{"issue":"4","key":"i2168-9709-15-5-232-b11","series-title":"West J Emerg Med","first-page":"728","article-title":"The incidence of QT prolongation and Torsades des Pointes in patients receiving droperidol in an urban emergency department","volume":"21","author":"Cole","year":"2020","unstructured":"Cole JB,\nLee SC,\nMartel ML,\nSmith SW,\nBiros MH,\nMiner JR. The incidence of QT prolongation and Torsades des Pointes in patients receiving droperidol in an urban emergency department. West J Emerg Med. 2020;21(4):728-36. 2020;21(4):728-36. 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