Summary of findings 4. Droperidol versus olanzapine.
| Droperidol versus olanzapine | ||||||
|
Patient or population: acute psychosis Setting: inpatient Intervention: droperidol Comparison: olanzapine | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with olanzapine | Risk with droperidol | |||||
| Tranquillisation or asleep: tranquillised/asleep ‐ by around 30 minutes | Moderate | RR 1.02 (0.94 to 1.11) | 221 (1 RCT) | ⊕⊕⊕⊕ High 1 | 'Moderate' control risk approximately that of trial population. | |
| 900 per 1000 | 918 per 1000 (846 to 999) | |||||
| Global state: use of additional medication ‐ by 60 minutes after initial adequate sedation until ED discharge (various psychotropic drugs) | Moderate | RR 0.56 (0.36 to 0.87) | 221 (1 RCT) | ⊕⊕⊕⊕ High 1 | 'Moderate' control risk approximately that of trial population. | |
| 370 per 1000 | 207 per 1000 (133 to 322) | |||||
| Adverse effects ‐ cardiovascular ‐ arrhythmia | Moderate | RR 0.32 (0.01 to 7.88) | 221 (1 RCT) | ⊕⊕⊕⊝ Moderate 1,2 | 'Moderate' control risk approximately that of trial population. | |
| 10 per 1000 | 3 per 1000 (0 to 79) | |||||
| Adverse effects ‐ respiratory ‐ airway obstruction | Moderate | RR 0.97 (0.20 to 4.72) | 221 (1 RCT) | ⊕⊕⊝⊝ Low 2,3 | 'Moderate' control risk approximately that of trial population. | |
| 30 per 1000 | 29 per 1000 (6 to 142) | |||||
| Service use: person able to be discharged home | Moderate | RR 1.06 (0.83 to 1.34) | 221 (1 RCT) | ⊕⊕⊕⊕ High 1 | 'Moderate' control risk approximately that of trial population. | |
| 530 per 1000 | 562 per 1000 (440 to 710) | |||||
| Mental state ‐ improvement | Study population | Not estimable | (0 studies) | ‐ | No trial reported this important outcome. | |
| Not pooled | Not pooled | |||||
| 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; 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 Imprecision: rated 'serious' (downgraded by 1) ‐ few events, wide confidence intervals.
3 Indirectness: rated 'serious' (downgraded by 1) ‐ respiratory obstruction proxy measure ‐ not 'death'.