Haloperidol vs Droperidol

Q: 52 years old male admitted to ICU for acute psychosis became violent towards medical staff. Pharmacy suggested Droperidol. How Droperidol is different from Haloperidol?

Answer: Droperidol has an advantage over haloperidol in that it has:

• more rapid onset of action 
• shorter duration of effect
• can be used as monotherapy
• IM works as well as IV 

Droperidol is an analog of haloperidol. It has an advantage over haloperidol, with a more rapid onset of action (3-10 minutes) and a shorter duration of action (2-4 hours). In contrast, the onset of action of haloperidol, whether given intravenously (IV) or intramuscularly (IM), occurs within 30 to 60 minutes, and the duration of action can last up to a full day. Droperidol can be given IV or IM; however, compared with haloperidol, IM droperidol is rapidly absorbed and is preferable if the patient is not cooperative enough to allow IV access. Administration of Haloperidol usually requires co-administration of other drugs such as benzodiazepines, whereas droperidol works well as a monotherapy. 

#psychiatry

#pharmacology

References:

1. Battaglia J. Pharmacological management of acute agitation. Drugs 2005; 65:1207.

2. Thomas H Jr, Schwartz E, Petrilli R. Droperidol versus haloperidol for chemical restraint of agitated and combative patients. Ann Emerg Med 1992; 21:407.

3. Knott JC, Taylor DM, Castle DJ. Randomized clinical trial comparing intravenous midazolam and droperidol for sedation of the acutely agitated patient in the emergency department. Ann Emerg Med 2006; 47:61.

4. Page CB, Parker LE, Rashford SJ, et al. A Prospective Before and After Study of Droperidol for Prehospital Acute Behavioral Disturbance. Prehosp Emerg Care 2018; 22:713.