Summary of findings 2. Droperidol versus haloperidol.
| Droperidol versus haloperidol | ||||||
|
Patient or population: acute psychosis Setting: inpatient Intervention: droperidol Comparison: haloperidol | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with haloperidol | Risk with droperidol | |||||
| Tranquillisation or asleep: tranquillised/sleep ‐ by around 30 minutes | Moderate | RR 1.01 (0.93 to 1.09) | 228 (1 RCT) | ⊕⊕⊕⊕ High 1 | 'Moderate' control risk approximately that of trial population. | |
| 920 per 1000 | 929 per 1000 (856 to 1000) | |||||
| Global state: use of additional medication ‐ by 60 minutes after initial adequate sedation until ED discharge (various psychotropic drugs) | Moderate | RR 0.37 (0.16 to 0.90) | 255 (2 RCTs) | ⊕⊕⊕⊕ High 1,2 | 'Moderate' control risk approximately that of trial population. | |
| 160 per 1000 | 59 per 1000 (26 to 144) | |||||
| Adverse effects ‐ cardiovascular ‐ hypotension | Moderate | RR 2.80 (0.30 to 26.49) | 228 (1 RCT) | ⊕⊕⊕⊝ Moderate 1,3 | 'Moderate' control risk approximately that of trial population. | |
| 10 per 1000 | 28 per 1000 (3 to 265) | |||||
| Adverse effects ‐ cardiovascular ‐ hypotension/desaturation | Study population | RR 2.80 (0.12 to 67.98) | 228 (1 RCT) | ⊕⊕⊝⊝ Low 1,3,4 | 'Moderate' control risk approximately that of trial population. | |
| 0 per 1000 | 0 per 1000 (0 to 0) | |||||
| Service use: person able to be discharged home | Study population | Not pooled | (0 studies) | ‐ | No trial reported this important outcome. | |
| Not pooled | Not pooled | |||||
| Mental state: mean score by 13 days (Scale for Quantification of Psychotic Symptom Severity, high = poor) | The mean mental state: mean score by 13 days (Scale for Quantification of Psychotic Symptom Severity, high = poor) was 0 | The mean mental state: mean score by 13 days (Scale for Quantification of Psychotic Symptom Severity, high = poor) in the intervention group was 0.11 undefined more (0.07 fewer to 0.29 more) | MD 0.11 CI ‐0.07 to 0.29 |
40 (1 RCT) | ⊕⊕⊝⊝ Low 1,3,4 | 'Moderate' control risk approximately that of trial population. |
| Economic: direct costs | Study population | Not estimable | (0 studies) | ‐ | No trial reported this important outcome. | |
| Not pooled | Not pooled | |||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; ED: emergency department; MD: mean difference; RCT: randomised controlled trial; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence High quality: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect. | ||||||
1 Risk of bias: rated 'not serious' (no downgrade) ‐ clear reporting of good methods.
2 Indirectness: rated 'not serious' (no downgrade) ‐ but proxy outcome for 'Another episode of aggression by 24 hours'.
3 Imprecision: rated 'serious' (downgraded by 1) ‐ few events, wide confidence intervals.
4 Indirectness: rated 'serious' (downgraded by 1) ‐ hypotension/desaturation proxy measure ‐ not 'death'.