A Prospective, Double-blind, Randomized Trial of Midazolam versus Haloperidol versus Lorazepam in the Chemical Restraint of Violent and Severely Agitated Patients

A Comparison of the Safety of Olanzapine and Haloperidol in Combination with Benzodiazepines in Emergency Department Patients with Acute Agitation

“…This is surprising because many emergency physicians are likely to be cautious in treating actively intoxicated patients with benzodiazepines, but may simply reflect treatment of withdrawal despite a positive alcohol level (1,(11)(12)(13)(14). Although the number of patients in this report is insufficient to establish the safety of benzodiazepines in intoxicated patients, it does suggest that administration of small amounts of this class of medications is not likely to cause significant harm.…”

The Use of Chemical Restraints Reduces Agitation in Patients Transported by Emergency Medical Services

“…One study comparing i.m. midazolam, haloperidol, and lorazepam in restraining violent and severely agitated ED patients found that midazolam achieved more rapid control of patients than lorazepam or haloperidol (31). There has been a reluctance to add protocols for CRs with benzodiazepines due to the potential side affects, especially given that alcohol ingestion is not always known before CR on scene.…”

The use of intramuscular benzodiazepines and antipsychotic agents in the treatment of acute agitation or violence in the emergency department

“…In a study evaluating the effectiveness of midazolam in treating agitation, 5 mg of intramuscular midazolam was superior to 10 mg of haloperidol (11). In a study comparing the use of intramuscular midazolam, haloperidol, and lorazepam in restraining violent and severely agitated patients, midazolam was found to more quickly control patients than lorazepam or haloperidol (12). Although acute onset of action is ideal, one potential drawback with midazolam may be its relatively short half-life.…”