Table 4

Studies assessing the safety of pharmacological agents used for agitated behaviours in TBI

Study/year/nDrugs studiedResults
Rao50/1985/n=26HaloperidolTwenty-five patients exhibited agitation and 11 patients required haloperidol. In an unadjusted analysis, the haloperidol patients have a significantly longer period (8 vs 4 weeks; p<0.03) of post-traumatic amnesia (PTA).
Mysiw49/2006/n=182Narcotics, benzodiazepines and neurolepticsNarcotics, benzodiazepines and neuroleptics had no effect on the Function Independence Measures (FIM) motor and independence scores. In an unadjusted analysis, narcotics and neuroleptics increased duration of PTA by >7 days (p<0.01).
AntipsychoticsFifty-two patients received antipsychotics (26.7%) within 7 days of TBI, mostly quetiapine. In an unadjusted analysis, duration of PTA was significantly longer (19.6 vs 12.3 days; p=0.013) in patients treated with antipsychotics.
HaloperidolIn an unadjusted analysis, there was no significant increase in adverse events (QT prolongation, seizures, neuroleptic malignant syndrome, extrapyramidal symptoms or haematological disturbances) associated with haloperidol use. Patients in the haloperidol group who developed complications received a higher mean daily dose (p=0.013). There was no difference in length of mechanical ventilation but the haloperidol group had a longer hospital length of stay (22 vs 11 days; p<0.001).
  • TBI, traumatic brain injury.