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Antipsychotics best for quick ED sedation

Severely agitated emergency department patients are best sedated with a combination of antipsychotic drugs, a study has found.

Droperidol or olanzapine in combination with midazolam is fast and effective in sedating aggressive patients and they are less likely to require re-sedation, according to researchers from the Monash University, Austin Health, Royal Melbourne Hospital and St Vincent’s.

“This drug combination is safe, fast and inexpensive and we found no negative effect,” said Professor David Taylor from the emergency department (ED) at Austin Health. “The findings underscore the need for rapid and lasting sedating regimens in the ED.”

The study involved 336 adult patients with acute agitation requiring intravenous sedation in three Australian EDs.

“Agitation and aggression are frequently observed in patients admitted to the emergency department as a result of mental illness or drug or alcohol intoxication,” said Dr David Kong, from the Centre for Medicine Use and Safety. “We have compared three commonly used drug regimens in order to evaluate their safety and efficacy for the sedation of acutely agitated patients.

“More effective management of acute agitation could significantly reduce stress and maximise the safety of both the patients and health professionals.”

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