A Review of the Safety and Efficacy of Droperidol for the Rapid Sedation of Severely Agitated and Violent Patients.
J Clin Psychiatry 2003;64(5):500-505
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Droperidol had become a standard
treatment for sedating severely agitated or violent patients in
both psychiatric and medical emergency departments. However,
several recent articles have suggested that droperidol may have a
quinidine-like effect similar to that of thioridazine in inducing
Method: In view of the recent U.S. Food and Drug
Administration (FDA) position regarding the use of thioridazine,
the authors reviewed the literature regarding droperidol and
dysrhythmia in a MEDLINE search for the years 1960-2002 using the
search terms droperidol, dysrhythmia, QTc
interval, and sudden death as well as their own
experience in using droperidol in a busy psychiatric emergency
department. This review was done before the FDA's very recent and
peremptory warning about droperidol.
Results: The authors report that, in treating
approximately 12,000 patients over the past decade, they have
never experienced a clinically significant adverse dysrhythmic
event using droperidol to sedate severely agitated or violent
Conclusion: The authors conclude that, in
clinical practice, droperidol is an extremely effective and safe
method for treating severely agitated or violent patients. While
in theory droperidol may prolong the QT interval to an extent
similar to thioridazine, in clinical use there is no pattern of
sudden deaths analogous to those that provoked the FDA warning