Scolaris Content Display Scolaris Content Display

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 1 Tranquil or asleep: 1. Not tranquil or asleep.
Figures and Tables -
Analysis 1.1

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 1 Tranquil or asleep: 1. Not tranquil or asleep.

Study

Intervention

Mean (mins)

SD

N

Statistical test

p

TREC‐Vellore‐I

Haloperidol + promethazine

29.7

35.6

100

Mann‐Whitney U
327.0

<0.001

TREC‐Vellore‐I

Lorazepam

47.8

46.7

100

Figures and Tables -
Analysis 1.2

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 2 Tranquil or asleep: 2. Time until tranquil or asleep.

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 3 Tranquil or asleep: 3. Not asleep.
Figures and Tables -
Analysis 1.3

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 3 Tranquil or asleep: 3. Not asleep.

Study

Intervention

Mean (mins)

SD

N

Statistical test

p

TREC‐Vellore‐I

Haloperidol + promethazine

37.4

42.9

100

Mann‐Whitney U
1893.5

<0.001

TREC‐Vellore‐I

Lorazepam

80.6

64.3

100

Figures and Tables -
Analysis 1.4

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 4 Tranquil or asleep: 4. Time until asleep.

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 5 Adverse effects: 1. Serious adverse effect.
Figures and Tables -
Analysis 1.5

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 5 Adverse effects: 1. Serious adverse effect.

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 6 Adverse effects: 2. Extrapyramidal problems ‐ 0‐4 hours.
Figures and Tables -
Analysis 1.6

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 6 Adverse effects: 2. Extrapyramidal problems ‐ 0‐4 hours.

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 7 Global effect: 1. Additional tranquillising drugs.
Figures and Tables -
Analysis 1.7

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 7 Global effect: 1. Additional tranquillising drugs.

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 8 Global effect: 2. Not clinically improved.
Figures and Tables -
Analysis 1.8

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 8 Global effect: 2. Not clinically improved.

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 9 Global effect: 3. Average improvement (CGI).
Figures and Tables -
Analysis 1.9

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 9 Global effect: 3. Average improvement (CGI).

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 10 Global effect: 4. Needing restraints or seclusion.
Figures and Tables -
Analysis 1.10

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 10 Global effect: 4. Needing restraints or seclusion.

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 11 Global effect: 5. Other episode of aggression ‐ within 24 hours.
Figures and Tables -
Analysis 1.11

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 11 Global effect: 5. Other episode of aggression ‐ within 24 hours.

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 12 Global effect: 6. Doctor called to see patient.
Figures and Tables -
Analysis 1.12

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 12 Global effect: 6. Doctor called to see patient.

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 13 Global effect: 7. Refusing oral medication.
Figures and Tables -
Analysis 1.13

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 13 Global effect: 7. Refusing oral medication.

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 14 Service outcomes: Not discharged.
Figures and Tables -
Analysis 1.14

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 14 Service outcomes: Not discharged.

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 15 Leaving the study early.
Figures and Tables -
Analysis 1.15

Comparison 1 HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES, Outcome 15 Leaving the study early.

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 1 Tranquil or asleep: 1. Not tranquil or asleep.
Figures and Tables -
Analysis 2.1

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 1 Tranquil or asleep: 1. Not tranquil or asleep.

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 2 Tranquil or asleep: 3. Not asleep.
Figures and Tables -
Analysis 2.2

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 2 Tranquil or asleep: 3. Not asleep.

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 3 Adverse effects: 1. Any serious adverse effect.
Figures and Tables -
Analysis 2.3

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 3 Adverse effects: 1. Any serious adverse effect.

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 4 Adverse effects: 2. Acute dystonia.
Figures and Tables -
Analysis 2.4

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 4 Adverse effects: 2. Acute dystonia.

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 5 Adverse effects: 3. Seizure.
Figures and Tables -
Analysis 2.5

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 5 Adverse effects: 3. Seizure.

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 7 Global effect: 1. Additional tranquillising drugs.
Figures and Tables -
Analysis 2.7

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 7 Global effect: 1. Additional tranquillising drugs.

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 10 Global effect: 4. Needing restraints or seclusion.
Figures and Tables -
Analysis 2.10

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 10 Global effect: 4. Needing restraints or seclusion.

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 11 Global effect: 5. Other episode of aggression ‐ within 24 hours.
Figures and Tables -
Analysis 2.11

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 11 Global effect: 5. Other episode of aggression ‐ within 24 hours.

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 12 Global effect: 6. Doctor called to see patient.
Figures and Tables -
Analysis 2.12

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 12 Global effect: 6. Doctor called to see patient.

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 13 Global effect: 7. Refusing oral medication.
Figures and Tables -
Analysis 2.13

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 13 Global effect: 7. Refusing oral medication.

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 14 Service outcomes: Not discharged.
Figures and Tables -
Analysis 2.14

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 14 Service outcomes: Not discharged.

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 15 Leaving the study early.
Figures and Tables -
Analysis 2.15

Comparison 2 HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL, Outcome 15 Leaving the study early.

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 1 Tranquil or asleep: 1. Not tranquil or asleep.
Figures and Tables -
Analysis 3.1

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 1 Tranquil or asleep: 1. Not tranquil or asleep.

Study

Intervention

Mean (mins)

SD

N

Statistical test

p

TREC‐Vellore‐II

Haloperidol + Promethazine

12.8

16.7

150

Mann‐Whitney U

0.4

TREC‐Vellore‐II

Olanzapine

20.5

34.5

150

Figures and Tables -
Analysis 3.2

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 2 Tranquil or asleep: 2. Time until tranquil or asleep.

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 3 Tranquil or asleep: 3. Not asleep.
Figures and Tables -
Analysis 3.3

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 3 Tranquil or asleep: 3. Not asleep.

Study

Intervention

Mean (mins)

SD

N

Statistical test

p

TREC‐Vellore‐II

Haloperidol +
Promethazine

26.2

32.2

150

Mann‐Whitney U

0.2

TREC‐Vellore‐II

Olanzapine

34.9

42.2

150

Figures and Tables -
Analysis 3.4

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 4 Tranquil or asleep: 4. Time until asleep.

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 5 Tranquil or asleep: 5. Never tranquil or asleep during first 4 hrs.
Figures and Tables -
Analysis 3.5

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 5 Tranquil or asleep: 5. Never tranquil or asleep during first 4 hrs.

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 6 Adverse effects: 1. Serious adverse effect.
Figures and Tables -
Analysis 3.6

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 6 Adverse effects: 1. Serious adverse effect.

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 7 Adverse effects: 2. Extrapyramidal problems ‐ 0‐4 hours.
Figures and Tables -
Analysis 3.7

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 7 Adverse effects: 2. Extrapyramidal problems ‐ 0‐4 hours.

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 8 Global effect: 1. Requiring additional drugs during initial phase.
Figures and Tables -
Analysis 3.8

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 8 Global effect: 1. Requiring additional drugs during initial phase.

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 9 Global effect: 2. Not clinically improved.
Figures and Tables -
Analysis 3.9

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 9 Global effect: 2. Not clinically improved.

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 10 Global effect: 3. Average improvement (CGI).
Figures and Tables -
Analysis 3.10

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 10 Global effect: 3. Average improvement (CGI).

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 11 Global effect: 4. Needing restraints or seclusion.
Figures and Tables -
Analysis 3.11

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 11 Global effect: 4. Needing restraints or seclusion.

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 12 Global effect: 5. Further observation after 4 hours.
Figures and Tables -
Analysis 3.12

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 12 Global effect: 5. Further observation after 4 hours.

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 13 Global effect: 6. Doctor called to see patient.
Figures and Tables -
Analysis 3.13

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 13 Global effect: 6. Doctor called to see patient.

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 14 Global effect: 7. Taking oral drugs at 2 weeks.
Figures and Tables -
Analysis 3.14

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 14 Global effect: 7. Taking oral drugs at 2 weeks.

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 15 Service outcomes: 1. Not discharged.
Figures and Tables -
Analysis 3.15

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 15 Service outcomes: 1. Not discharged.

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 16 Service outcomes: 2. Admitted.
Figures and Tables -
Analysis 3.16

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 16 Service outcomes: 2. Admitted.

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 17 Leaving the study early.
Figures and Tables -
Analysis 3.17

Comparison 3 HALOPERIDOL + PROMETHAZINE vs OLANZAPINE, Outcome 17 Leaving the study early.

Table 1. Survey of rapid tranquillisation in Rio de Janeiro 2002

Drug of choice

Frequency of use

mean mg (range)

Haloperidol + promethazine

61%

5 (2.5‐10) + 50 (25‐100)

Haloperidol + promethazine + diazepam

15%

5 (2.5‐10) + 50 (25‐100) + 10

Diazepam

9%

10

Haloperidol + promethazine + chlorpromazine

7%

5 + 50 + 25

Chlorpromazine + diazepam + promethazine

1%

25 + 10 + 50

Chlorpromazine + promethazine

1%

25 + 50

Chlorpromazine

1%

25

Diazepam + promethazine

1%

10 + 50

Haloperidol + diazepam

1%

5 + 10

Promethazine

1%

50

Figures and Tables -
Table 1. Survey of rapid tranquillisation in Rio de Janeiro 2002
Comparison 1. HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Tranquil or asleep: 1. Not tranquil or asleep Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 by 30 minutes

2

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 by 1 hour

2

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 by 2 hours

2

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.4 by 4 hours

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Tranquil or asleep: 2. Time until tranquil or asleep Show forest plot

Other data

No numeric data

3 Tranquil or asleep: 3. Not asleep Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

3.1 by 30 minutes

2

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.2 by 1 hour

2

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.3 by 2 hours

2

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.4 by 4 hours

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 Tranquil or asleep: 4. Time until asleep Show forest plot

Other data

No numeric data

5 Adverse effects: 1. Serious adverse effect Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

5.1 by 30 minutes

2

501

Risk Ratio (M‐H, Fixed, 95% CI)

0.60 [0.08, 4.52]

5.2 by 1 hour

2

501

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.3 by 2 hours

2

501

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.4 by 4 hours

1

200

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 Adverse effects: 2. Extrapyramidal problems ‐ 0‐4 hours Show forest plot

1

Risk Difference (M‐H, Fixed, 95% CI)

Subtotals only

6.1 akathisia (Barnes Akathisia Scale)

1

200

Risk Difference (M‐H, Fixed, 95% CI)

0.0 [‐0.02, 0.02]

6.2 any change in scale‐rated extrapyramidal problems (Simpson & Angus Scale)

1

200

Risk Difference (M‐H, Fixed, 95% CI)

0.0 [‐0.02, 0.02]

7 Global effect: 1. Additional tranquillising drugs Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

7.1 by 30 minutes

1

200

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.01, 8.09]

7.2 by 1 hour

1

200

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.04, 3.15]

7.3 by 2 hours

2

501

Risk Ratio (M‐H, Fixed, 95% CI)

1.67 [0.62, 4.54]

7.4 by 4 hours

1

200

Risk Ratio (M‐H, Fixed, 95% CI)

0.89 [0.36, 2.21]

8 Global effect: 2. Not clinically improved Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

8.1 by 30 minutes

1

200

Risk Ratio (M‐H, Fixed, 95% CI)

0.40 [0.25, 0.66]

8.2 by 1 hour

1

200

Risk Ratio (M‐H, Fixed, 95% CI)

0.5 [0.32, 0.79]

8.3 by 2 hours

1

200

Risk Ratio (M‐H, Fixed, 95% CI)

0.46 [0.25, 0.86]

8.4 by 4 hours

1

200

Risk Ratio (M‐H, Fixed, 95% CI)

0.93 [0.46, 1.87]

9 Global effect: 3. Average improvement (CGI) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

9.1 by 30 minutes

1

200

Mean Difference (IV, Fixed, 95% CI)

‐0.60 [‐0.86, ‐0.34]

9.2 by 1 hour

1

200

Mean Difference (IV, Fixed, 95% CI)

‐0.33 [‐0.54, ‐0.12]

9.3 by 2 hours

1

200

Mean Difference (IV, Fixed, 95% CI)

‐0.23 [‐0.51, 0.05]

9.4 by 4 hours

1

200

Mean Difference (IV, Fixed, 95% CI)

‐0.09 [‐0.32, 0.14]

10 Global effect: 4. Needing restraints or seclusion Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

10.1 by 30 minutes

1

200

Risk Ratio (M‐H, Fixed, 95% CI)

0.55 [0.28, 1.09]

10.2 by 1 hour

1

200

Risk Ratio (M‐H, Fixed, 95% CI)

0.56 [0.27, 1.14]

10.3 by 2 hours

2

501

Risk Ratio (M‐H, Fixed, 95% CI)

1.09 [0.77, 1.56]

10.4 by 4 hours

1

200

Risk Ratio (M‐H, Fixed, 95% CI)

0.82 [0.35, 1.89]

11 Global effect: 5. Other episode of aggression ‐ within 24 hours Show forest plot

1

301

Risk Ratio (M‐H, Fixed, 95% CI)

0.89 [0.62, 1.29]

12 Global effect: 6. Doctor called to see patient Show forest plot

2

501

Risk Ratio (M‐H, Fixed, 95% CI)

0.82 [0.60, 1.10]

12.1 within 4 hours

1

200

Risk Ratio (M‐H, Fixed, 95% CI)

0.72 [0.37, 1.39]

12.2 within 24 hours

1

301

Risk Ratio (M‐H, Fixed, 95% CI)

0.85 [0.61, 1.19]

13 Global effect: 7. Refusing oral medication Show forest plot

2

501

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.59, 1.72]

13.1 within 24 hours

1

301

Risk Ratio (M‐H, Fixed, 95% CI)

0.69 [0.33, 1.44]

13.2 within 2 weeks

1

200

Risk Ratio (M‐H, Fixed, 95% CI)

1.63 [0.70, 3.75]

14 Service outcomes: Not discharged Show forest plot

2

501

Risk Ratio (M‐H, Fixed, 95% CI)

1.08 [0.91, 1.28]

14.1 by 4 hours

1

200

Risk Ratio (M‐H, Fixed, 95% CI)

1.13 [0.85, 1.50]

14.2 by 15 days

1

301

Risk Ratio (M‐H, Fixed, 95% CI)

1.05 [0.84, 1.29]

15 Leaving the study early Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

15.1 by 2 hours

1

301

Risk Ratio (M‐H, Fixed, 95% CI)

2.01 [0.18, 21.97]

15.2 by 4 hours

1

200

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.12, 72.77]

15.3 by 24 hours

1

301

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.36, 2.80]

15.4 by 2 weeks

2

501

Risk Ratio (M‐H, Fixed, 95% CI)

0.91 [0.41, 2.05]

Figures and Tables -
Comparison 1. HALOPERIDOL + PROMETHAZINE vs BENZODIAZEPINES
Comparison 2. HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Tranquil or asleep: 1. Not tranquil or asleep Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 by 20 minutes

1

316

Risk Ratio (M‐H, Fixed, 95% CI)

0.65 [0.49, 0.87]

1.2 by 40 mins

1

316

Risk Ratio (M‐H, Fixed, 95% CI)

0.83 [0.56, 1.24]

1.3 by 1 hour

1

316

Risk Ratio (M‐H, Fixed, 95% CI)

0.75 [0.46, 1.23]

1.4 by 2 hours

1

316

Risk Ratio (M‐H, Fixed, 95% CI)

0.55 [0.32, 0.96]

2 Tranquil or asleep: 3. Not asleep Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 by 20 minutes

1

316

Risk Ratio (M‐H, Fixed, 95% CI)

0.89 [0.82, 0.96]

2.2 by 40 minutes

1

316

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.85, 1.16]

2.3 by 1 hour

1

316

Risk Ratio (M‐H, Fixed, 95% CI)

1.04 [0.84, 1.28]

2.4 by 2 hours

1

316

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.77, 1.31]

3 Adverse effects: 1. Any serious adverse effect Show forest plot

1

298

Risk Ratio (M‐H, Fixed, 95% CI)

0.09 [0.01, 0.66]

3.1 by 24 hours

1

298

Risk Ratio (M‐H, Fixed, 95% CI)

0.09 [0.01, 0.66]

4 Adverse effects: 2. Acute dystonia Show forest plot

1

298

Risk Ratio (M‐H, Fixed, 95% CI)

0.05 [0.00, 0.76]

4.1 by 24 hours

1

298

Risk Ratio (M‐H, Fixed, 95% CI)

0.05 [0.00, 0.76]

5 Adverse effects: 3. Seizure Show forest plot

1

298

Risk Ratio (M‐H, Fixed, 95% CI)

0.95 [0.06, 15.01]

5.1 by 24 hours

1

298

Risk Ratio (M‐H, Fixed, 95% CI)

0.95 [0.06, 15.01]

7 Global effect: 1. Additional tranquillising drugs Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

7.1 by 2 hours

1

311

Risk Ratio (M‐H, Fixed, 95% CI)

0.45 [0.16, 1.25]

10 Global effect: 4. Needing restraints or seclusion Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

10.1 by 2 hours

1

311

Risk Ratio (M‐H, Fixed, 95% CI)

0.80 [0.54, 1.18]

11 Global effect: 5. Other episode of aggression ‐ within 24 hours Show forest plot

1

298

Risk Ratio (M‐H, Fixed, 95% CI)

1.17 [0.68, 2.01]

12 Global effect: 6. Doctor called to see patient Show forest plot

1

298

Risk Ratio (M‐H, Fixed, 95% CI)

0.66 [0.44, 0.99]

12.1 within 24 hours

1

298

Risk Ratio (M‐H, Fixed, 95% CI)

0.66 [0.44, 0.99]

13 Global effect: 7. Refusing oral medication Show forest plot

1

294

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.54, 1.97]

13.1 within 24 hours

1

294

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.54, 1.97]

14 Service outcomes: Not discharged Show forest plot

1

310

Risk Ratio (M‐H, Fixed, 95% CI)

0.83 [0.64, 1.07]

14.1 by 2 weeks

1

310

Risk Ratio (M‐H, Fixed, 95% CI)

0.83 [0.64, 1.07]

15 Leaving the study early Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

15.1 before treatment

1

316

Risk Ratio (M‐H, Fixed, 95% CI)

1.46 [0.25, 8.63]

15.2 by 24 hours

1

316

Risk Ratio (M‐H, Fixed, 95% CI)

0.89 [0.41, 1.97]

15.3 by 2 weeks

1

316

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.20, 4.76]

Figures and Tables -
Comparison 2. HALOPERIDOL + PROMETHAZINE vs HALOPERIDOL
Comparison 3. HALOPERIDOL + PROMETHAZINE vs OLANZAPINE

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Tranquil or asleep: 1. Not tranquil or asleep Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 by 15 mins

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.74 [0.38, 1.41]

1.2 by 30 minutes

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.6 [0.22, 1.61]

1.3 by 1 hour

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.11 [0.01, 0.87]

1.4 by 2 hours

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.44 [0.14, 1.41]

1.5 by 4 hours

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.83 [0.26, 2.67]

2 Tranquil or asleep: 2. Time until tranquil or asleep Show forest plot

Other data

No numeric data

3 Tranquil or asleep: 3. Not asleep Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 by 15 mins

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.75 [0.60, 0.95]

3.2 by 30 minutes

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.65 [0.46, 0.93]

3.3 by 1 hour

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.59 [0.40, 0.87]

3.4 by 2 hours

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.24 [0.14, 0.41]

3.5 by 4 hours

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.61 [0.44, 0.86]

4 Tranquil or asleep: 4. Time until asleep Show forest plot

Other data

No numeric data

5 Tranquil or asleep: 5. Never tranquil or asleep during first 4 hrs Show forest plot

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.25 [0.03, 2.21]

6 Adverse effects: 1. Serious adverse effect Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

6.1 by 4 hours

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.04, 3.17]

6.2 at 2 weeks

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.01, 8.12]

7 Adverse effects: 2. Extrapyramidal problems ‐ 0‐4 hours Show forest plot

1

Risk Difference (M‐H, Fixed, 95% CI)

Subtotals only

7.1 any change in scale‐rated extrapyramidal problems (Simpson & Angus Scale)

1

300

Risk Difference (M‐H, Fixed, 95% CI)

0.0 [‐0.01, 0.01]

8 Global effect: 1. Requiring additional drugs during initial phase Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

8.1 by 4 hours

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.48 [0.33, 0.69]

9 Global effect: 2. Not clinically improved Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

9.1 by 15 mins

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.79 [0.56, 1.11]

9.2 by 30 minutes

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.58 [0.36, 0.91]

9.3 by 1 hour

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.4 [0.21, 0.75]

9.4 by 2 hours

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.44 [0.24, 0.79]

9.5 by 4 hours

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.47 [0.22, 1.01]

10 Global effect: 3. Average improvement (CGI) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

10.1 by 15 mins

1

300

Mean Difference (IV, Fixed, 95% CI)

‐0.28 [‐0.51, ‐0.05]

10.2 by 30 minutes

1

300

Mean Difference (IV, Fixed, 95% CI)

‐0.35 [‐0.58, ‐0.12]

10.3 by 1 hour

1

300

Mean Difference (IV, Fixed, 95% CI)

‐0.41 [‐0.60, ‐0.22]

10.4 by 2 hours

1

300

Mean Difference (IV, Fixed, 95% CI)

‐0.36 [‐0.56, ‐0.16]

10.5 by 4 hours

1

300

Mean Difference (IV, Fixed, 95% CI)

‐0.27 [‐0.43, ‐0.11]

11 Global effect: 4. Needing restraints or seclusion Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

11.1 by 15 mins

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.96 [0.67, 1.36]

11.2 by 30 minutes

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.71, 1.47]

11.3 by 1 hour

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.66, 1.44]

11.4 by 2 hours

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.79 [0.51, 1.25]

11.5 by 4 hours

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.63 [0.34, 1.14]

12 Global effect: 5. Further observation after 4 hours Show forest plot

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

1.17 [0.80, 1.71]

13 Global effect: 6. Doctor called to see patient Show forest plot

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.47 [0.30, 0.73]

13.1 within 4 hours

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.47 [0.30, 0.73]

14 Global effect: 7. Taking oral drugs at 2 weeks Show forest plot

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.96 [0.89, 1.04]

15 Service outcomes: 1. Not discharged Show forest plot

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.94 [0.77, 1.16]

15.1 after 4 hours

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.94 [0.77, 1.16]

16 Service outcomes: 2. Admitted Show forest plot

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.81 [0.56, 1.16]

16.1 after 4 hours

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.81 [0.56, 1.16]

17 Leaving the study early Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

17.1 by 15 mins

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.01, 8.12]

17.2 by 30 mins

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.01, 8.12]

17.3 by 60 mins

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.01, 8.12]

17.4 by 120 mins

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.14 [0.01, 2.74]

17.5 by 240 mins

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.09 [0.01, 1.63]

17.6 by 2 weeks

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

0.71 [0.33, 1.56]

Figures and Tables -
Comparison 3. HALOPERIDOL + PROMETHAZINE vs OLANZAPINE