@article{ref1,
title="Rapid tranquillisation in a psychiatric emergency hospital in Lebanon: TREC-Lebanon - a pragmatic randomised controlled trial of intramuscular haloperidol and  promethazine v. intramuscular haloperidol, promethazine and chlorpromazine",
journal="Psychological medicine",
year="2021",
author="Ikdais, Werner Henry and Yaacoub, Hiba Edward and Azar, Jocelyn and Haddad, Georges and Tahan, Fouad and Kazour, Francois and Hachem, Dory and Dib, Joseph E. and Akkari, Myriam and Ajaltouni, Jean and Merheb, Tony Jean and Atallah, Elie and Haddad, Chadia and Zoghbi, Marouan and Nasr, Maria Elias and Mourad, Marc and Adams, Clive E. and Hallit, Souheil",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Agitated patients constitute 10% of all emergency psychiatric treatment. Management guidelines, the preferred treatment of clinicians differ in opinion and  practice. In Lebanon, the use of the triple therapy haloperidol plus promethazine  plus chlorpromazine (HPC) is frequently used but no studies involving this  combination exists. <br><br>METHOD: A pragmatic randomised open trial (September 2018-July  2019) in the Lebanese Psychiatric Hospital of the Cross in Beirut Lebanon involving  100 people requiring urgent intramuscular sedation due to aggressive behaviour were  given intramuscular chlorpromazine 100 mg plus haloperidol 5 mg plus promethazine 25  mg (HPC) or intramuscular haloperidol 5 mg plus promethazine 25 mg. <br><br>RESULTS: Primary  outcome data were available for 94 (94%) people. People allocated to the haloperidol  plus promethazine (HP) group showed no clear difference at 20 min compared with  patients allocated to the HPC group [relative risk (RR) 0.84, 95% confidence  interval (CI) 0.47-1.50]. <br><br>CONCLUSIONS: Neither intervention consistently impacted  the outcome of 'calm', or 'asleep' and had no discernible effect on the use of  restraints, use of additional drugs or recurrence. If clinicians are faced with  uncertainty on which of the two intervention combinations to use, the simpler HP is  much more widely tested and the addition of chlorpromazine adds no clear benefit  with a risk of additional adverse effects.<p /> <p>Language: en</p>",
language="en",
issn="0033-2917",
doi="10.1017/S0033291720004869",
url="http://dx.doi.org/10.1017/S0033291720004869"
}