A PROSPECTIVE RANDOMIZED DOUBLE-BLIND CONTROLLED-STUDY OF THE EFFICACY OF LORAZEPAM VERSUS CLOTHIAPINE IN THE CONTROL OF ACUTELY BEHAVIORALLY DISTURBED PATIENTS

Objective. This study was undertaken to compare the efficacy of loraze pam with clothiapine in the behavioural control of acutely behavioural ly disturbed patients who are on antipsychotic treatment with haloperi dol. Design. This was a double-blind, controlled randomised trial. Pat ients. Sixty patients consecutively admitted to Sterkfontein Hospital aged between 18 and 45 years with aggressive and disorganised behaviou r were selected for the study. Methods. All the patients were treated with haloperidol 10 mg orally, and either clothiapine 40 mg or lorazep am 4 mg intramuscularly. Efficacy was measured using the Brief Psychia tric Rating Scale (BPRS) on admission, day 3 and day 7. Levels of aggr ession were assessed by the Overt Aggression Scale (OAS), This was don e on admission and on days 1, 3 and 7. The presence of extrapyramidal side-effects was assessed by the Simpson Angus Scale (SAS) on days 1, 3 and 7. Results. There were no significant differences between the tw o groups in respect of onset of sedation, demographics or rating scale scores on each visit. However, lorazepam treatment was associated wit h fewer extrapyramidal side-effects as measured by the SAS. Conclusion . Lorazepam and clothiapine are of equivalent efficacy in the control of acutely behaviourally disturbed patients. Lorazepam treatment is as sociated with fewer extrapyramidal side-effects.