Droperidol and Haloperidol Use in Psychotic and Agitated Patients

Authors

• Leah D. Rice, University of LynchburgFollow

Specialty

Emergency Medicine

Abstract

Acute psychosis and agitation creates a high-risk environment by threatening the safety of patients and providers and delaying care. The purpose of this review was to evaluate whether droperidol, compared with haloperidol, decreases the requirement for additional sedation while keeping a safe and reduced adverse-effect profile in adult patients presenting with acute psychosis and agitation.

A structured literature search was performed using PubMed and Google Scholar. Randomized controlled trials, systematic reviews, and clinically relevant comparative studies examining droperidol versus haloperidol in acute agitation or psychosis were included. Key publications that met the inclusion criteria underwent critical analysis. A randomized controlled trial published in 2015 demonstrated no statistically significant difference in sedation or rate of adverse side effects between IM droperidol and haloperidol. However, the primary data showed droperidol had more hypotensive effects on patients, and haloperidol required additional sedation. A multicenter retrospective cohort study conducted in 2025 in emergency department patients found droperidol to be associated with fewer repeat doses or adjunct medications being used. A 2016 Cochrane systematic review similarly reported reduced need for additional sedation with droperidol. An earlier double-blind study from 1984 observed markedly higher redosing requirements among patients treated with haloperidol during initial management than with droperidol.

Current literature suggests droperidol may decrease the need for supplemental sedation compared with haloperidol, though adverse-effect patterns differ across studies, and overall evidence remains limited. Large-scale randomized trials comparing droperidol and haloperidol are needed to better compare safety and efficacy. Optimizing pharmacologic management and ensuring effective and reliable sedation in acute psychiatric emergencies is essential in improving patient outcomes, enhancing staff safety, and enabling timely medical evaluation.

Recommended Citation

Rice LD. Droperidol and Haloperidol Use in Psychotic and Agitated Patients. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2026; 8(1).