A busy urban emergency department prospectively compared two IM treatments for patients with agitation who presented to their intoxication unit. The choice of treatment was dependent on availability. When droperidol was available, 5 mg was administered and when olanzapine was available, 10 mg was administered. The primary outcome was time to adequate sedation, which was a score of zero on the Altered Mental Status Scale. Which medication had a faster time to adequate sedation?
Neither. The median time to adequate sedation was 16 minutes for droperidol and 17.5 minutes for olanzapine. More patients in the olanzapine group required rescue medications (24%) compared to droperidol (17%).
Cole JB, Stang JL, DeVries PA, Martel ML, Miner JR, Driver BE. A Prospective Study of Intramuscular Droperidol or Olanzapine for Acute Agitation in the Emergency Department: A Natural Experiment Owing to Drug Shortages. Ann Emerg Med. 2021 Aug;78(2):274-286. doi: 10.1016/j.annemergmed.2021.01.005. Epub 2021 Apr 9. PMID: 33846015.
Submitted by: Kirk Cumpston, DO FAACT on behalf of Virginia Commonwealth University Medical Toxicology Fellowship