Intravenous Haloperidol versus Midazolam in Management of Conversion Disorder; a Randomized Clinical Trial
Journal Title: Archives of Academic Emergency Medicine - Year 2018, Vol 6, Issue 1
Abstract
Introduction: Conversion disorder is a condition in which the patient shows psychological stress in physical ways. This study aimed to compare the effects of haloperidol versus midazolam in patients with conversion disorder. Methods: This double-blind randomized clinical trial was conducted on patients with conversion disorder who had presented to the emergency department, throughout 2015. Patients were randomly divided into two groups and were either treated with 2.5 mg of intravenous (IV) haloperidol or 2.5 mg of IV midazolam. Recovery rate, time to recovery, and side effects of both drugs 1 hour, 24 hours, and 1 week after treatment were compared using SPSS19. Results: 140 patients were divided into two groups of 70. There were no significant differences between the groups regarding the baseline characteristics. 12 (17.1%) patients who were treated with IV haloperidol experienced drug side effects within 1 hour and 12 (17.1%) within 24 hours, while only 3 (4.3%) patients in IV midazolam experienced side-effects within 1 hour after drug administration (p = 0.026). The symptoms of the disease subsided in 45 (success rate: 64.3%) patients in midazolam and in 64 (success rate: 91.5%) participants in haloperidol group (P<0.001). Mean recovery time was 31.24 ± 7.03 minutes in IV midazolam and 30.53 ± 7.11 minutes in IV haloperidol group (p = 0.592). Absolute risk reduction (ARR) of treating patients with haloperidol compared to midazolam is about 27%. Conclusion: The response of patients to treatment with haloperidol is clearly better than midazolam. Although more transient and minor side-effects were observed in the group treated with haloperidol compared to midazolam group, serious side-effects were rare for both treatments.
Familiarity of Physicians and Nurses with Different Aspects of Oxygen Therapy; a Brief Report
Introduction: Oxygen is a drug and physician and nurses should be familiar with the effects and potential risks of oxygen therapy. The current study aimed to assess familiarity of physicians and nurses with various aspec...
A 52-Year-Old Woman with a Palpable Abdominal Mass
A 52-year-old woman was presented to the emergency de-partment with complaint of unspecific abdominal pain and a 2-week hypermenorrhea. The patient did not have nausea, vomiting, fever, or any other symptoms. She had a h...
Epidural Hematoma Following Hemodialysis in a Methanol Poisoned Pa-tient; a Case Report
Brain injury associated with methanol toxicity can be ischemic, necrotic or hemorrhagic in nature. It most commonly affects the putamen area bilaterally; however, it can be seen in other locations. This report describes...
Epidemiological Pattern of Injuries in Iran; a Nationwide Review of Seven Million Emergency Department Admissions
Introduction: Globally, it is estimated that around 5.8 million people die annually as result of injuries, which causes 10% of all deaths and 16% of disability adjusted life years lost worldwide. This study aimed to dete...
Evidence Based Emergency Medicine Part 3: Positive and Negative Likelihood Ratios of Diagnostic Tests
In the previous two parts of educational manuscript series in Emergency, we explained some screening characteris-tics of diagnostic tests including accuracy, sensitivity, specificity, and positive and negative predictive...