Revista Colombiana de Psiquiatría
Print version ISSN 0034-7450
POLANIA-DUSSAN, Irina Goretty; TORO-HERRERA, Sandra Milena and ESCOBAR-CORDOBA, Franklin. Midazolam and Haloperidol Use in Psychiatric Emergencies. rev.colomb.psiquiatr. [online]. 2009, vol.38, n.4, pp. 693-704. ISSN 0034-7450.
Introduction: Behavioral emergencies are the main psychiatric emergencies, due to the risk of aggressive behavior towards other people, healthcare professionals, the physical environment and the patient himself. In Colombia, the combination of midazolam and haloperidol is widely used in the management of this type of emergencies. Evidence supporting its use is not available. Objective: The aim of this study is to find evidence that supports the application of this therapeutic combination. Methods: A search was made in databases such as PubMed, MedLine, HINARI, OVID, Lilacs, SciELO, and PsycInfo. The combinations of keywords used in this search in MeSH Database were: Emergency services, psychiatric, psychomotor agitation, midazolam, and haloperidol. Applied limits were: published articles from 2000, systematic reviews, meta-analysis, controlled clinical trials and reviews. Results: The search rendered 146 articles in relation to the use of haloperidol and midazolam in behavioral emergencies. The abstract of each article was carefully read and 11 of them were selected. These articles were later analyzed but no article was found that supports the use of midazolam in combination with haloperidol in the treatment of psychomotor agitation. Conclusions: There is not available evidence in the reviewed literature that allows the use of the aforementioned combination in psychiatric emergencies. There were only articles that compare midazolam and haloperidol between them or with other therapeutic options. We find it necessary to perform a RCT that compares these two medications in order to obtain acceptable evidence for their use.
Keywords : Psychomotor agitation; haloperidol; midazolam; psychiatric emergency services.