Re:Emergency Department Protocol for acute psychosis

Usually for cost and convenience haloperidol 5mg to 10mg i.m. is used for agitated psychosic patients. Sometimes 2mg of lorazepam is also given i.m. if needed. Protocol will change according to the hospital. Some places use Clopixol Accuphase in place of haloperidol.

Supplement 14 of the Journal of Clinical Psychiatry has an article on the use of atypical antipsychotics (liquid risperidone + oral lorazepam) in emergency psychiatric situations.

Double check a textbook of emergency psychiatry as the above mentioned procedures do all have limitations. You could also phone the nearest teaching hospital and ask what they commonly use. It may be worth the cost of a telephone call.

Hope this helps - Cam

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