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Haloperidol plus promethazine effective for psychosis induced aggression

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Question

Question:

Is haloperidol plus promethazine an effective treatment for aggressive episodes caused by psychotic illness?

Outcomes:

Primary outcomes were not being tranquil or asleep within 30 min, another episode of aggression by 24 h, specific and serious adverse events by 24 h.

Methods

Design:

Systematic review with meta-analysis.

Data sources:

The Cochrane Schizophrenia Group Register was searched in January 2008 for this update of the review, and July 2004 for the original review. Reference lists of included and excluded studies and specific journals were hand searched. Study authors were also contacted.

Study selection and analysis:

Two reviewers independently selected randomised controlled trials of haloperidol plus promethazine, haloperidol alone, other antipsychotics, benzodi-azepine, anticonvulsive or haloperidol plus benzodiazepine, all given at any dose intramuscularly, compared with placebo or no intervention. Inclusion criteria: studies of people currently in an aggressive episode due to psychotic illness reporting tranquillity or being asleep, overall improvement and adverse events. Two reviewers independently performed data extraction and quality assessment. Relative risks (RR) were calculated for dichotomous outcomes and mean differences for continuous outcomes. Numbers needed to harm (NNH) were calculated for adverse events. Where possible, results …

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