Abstract
Aims and Method We conducted a postal questionnaire survey of the practice of rapid tranquillisation among 215 consultant psychiatrists in the West of Scotland, before and after the withdrawal of droperidol by the manufacturer. Results One hundred and eighty questionnaires (84% of those sent) were returned. Droperidol had been used extensively, often combined with lorazepam, for rapid tranquillisation. The main replacement suggested for droperidol was haloperidol. About half of the respondents to our survey chose to comment on the withdrawal of droperidol. More than half of the comments were unfavourable, including lack of an adequate replacement and lack of consultation with the psychiatric profession. Clinical Implications The abrupt withdrawal of droperidol, partly for commercial reasons, was regrettable. There was no time for an adequate evaluation of possible replacement medications and a lack of consultation with the profession regarding the impact on clinical care.
Highlights
Droperidol’s manufacturer, Janssen-Cilag Ltd., wrote to health care professionals in January 2001 to inform them that the Droleptan product range was to be withdrawn, because of a risk-benefit analysis that had highlighted the potential effect of droperidol on the cardiac QTc interval
We believed that droperidol was used extensively on psychiatric wards for rapid tranquillisation in emergency situations
A questionnaire was sent to all known consultant psychiatrists working within the West Scotland region
Summary
One hundred and eighty questionnaires (84% of those sent) were returned. Droperidol had been used extensively, often combined with lorazepam, for rapid tranquillisation. About half of the respondents to our survey chose to comment on the withdrawal of droperidol. More than half of the comments were unfavourable, including lack of an adequate replacement and lack of consultation with the psychiatric profession. There was no time for an adequate evaluation of possible replacement medications and a lack of consultation with the profession regarding the impact on clinical care. Droperidol’s manufacturer, Janssen-Cilag Ltd., wrote to health care professionals in January 2001 to inform them that the Droleptan product range was to be withdrawn, because of a risk-benefit analysis that had highlighted the potential effect of droperidol on the cardiac QTc interval. The reason for withdrawal of the injectable form was ‘commercial viability’. We believed that droperidol was used extensively on psychiatric wards for rapid tranquillisation in emergency situations. The purpose of this study was to ascertain prescribing habits before droperidol’s discontinuation, to identify what was proposed in its place and to ask clinicians’ opinions on the matter
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