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Title: | Intravenous midazolam-droperidol combination, droperidol or olanzapine monotherapy for methamphetamine-related acute agitation: subgroup analysis of a randomized controlled trial. |
Authors: | Yap, Celene Y. L. Taylor, David McD Knott, Jonathan C. Taylor, Simone E. Phillips, Georgina A. Karro, Jonathan Chan, Esther W. Kong, David C. M. Castle, David J. |
Issue Date: | 2017 |
Publication Title: | Addiction |
Volume: | 112 |
Issue: | 7 |
Start Page: | 1262 |
End Page: | 1269 |
Abstract: | AIM: To examine the efficacy and safety of (1) midazolam-droperidol versus droperidol and (2) midazolam-droperidol versus olanzapine for methamphetamine-related acute agitation. DESIGN AND SETTING: A multi-centre, randomized, double-blind, controlled, clinical trial was conducted in two Australian emergency departments, between October 2014 and September 2015. PARTICIPANTS: Three hundred and sixty-one patients, aged 18-65 years, requiring intravenous medication sedation for acute agitation, were enrolled into this study. We report the results of a subgroup of 92 methamphetamine-affected patients. INTERVENTION AND COMPARATOR: Patients were assigned randomly to receive either an intravenous bolus of midazolam 5 mg-droperidol 5 mg combined, droperidol 10 mg or olanzapine 10 mg. Two additional doses were administered, if required: midazolam 5 mg, droperidol 5 mg or olanzapine 5 mg, respectively. MEASUREMENTS: The primary outcome was the proportion of patients sedated adequately at 10 minutes. Odds ratios with 95% confidence intervals (ORs, 95% CI) were estimated. FINDINGS: The baseline characteristics of patients in the three groups were similar. At 10 minutes, significantly more patients in the midazolam-droperidol group [29 of 34 (85.3%)] were sedated adequately compared with the droperidol group [14 of 30 (46.7%), OR = 6.63, 95% CI = 2.02-21.78] or with the olanzapine group [14 of 28 (50.0%), OR 5.80, 95% CI = 1.74-19.33]. The number of patients who experienced an adverse event (AE) in the midazolam-droperidol, droperidol and olanzapine groups was seven of 34, two of 30 and six of 28, respectively. The most common AE was oxygen desaturation. CONCLUSION: A midazolam-droperidol combination appears to provide more rapid sedation of patients with methamphetamine-related acute agitation than droperidol or olanzapine alone. |
URI: | http://hdl.handle.net/11054/1064 |
ISSN: | 0965-2140 |
DOI: | 10.1111/add.13780 |
Internal ID Number: | 01031 |
Health Subject: | BENZODIAZEPINES DROPERIDOL EMERGENCY CARE METHAMPHETAMINE MIDAZOLAM OLANZAPINE PSYCHOMOTOR AGITATION SEDATION |
Type: | Journal Article Article |
Appears in Collections: | Research Output |
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