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Rapid tranquillisation: a questionnaire survey of practice

Rehabilitation Service, Harrop House, Prestwich Hospital, Bury New Road, Prestwich, Manchester M25 3BC

Ian Anderson, Senior Lecturer in Psychiatry^*

University of Manchester Department of Psychiatry, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL

^* Correspondence

A postal survey of the drug treatment of behavioural emergencies by senior registrars and consultants in psychiatry revealed that 90% would initially use a non-depot antipsychotic (including 24% who would combine it with a benzodiazepine if the situation warranted), and 10% the short-acting depot, zuclopenthixol acetate, with another antipsychotic or a benzodiazepine, or both. The choice was made from a restricted range of drugs, with haloperidol being the most popular antipsychotic and diazepam the most popular benzodiazepine. Half of respondents did not consider British National Formulary maximum dose recommendations to be useful for rapid tranquillisation and many would exceed them. A substantial minority did not consider that adequate resuscitation was available at their unit and deficiencies were revealed in the training of junior doctors and in the audit of rapid tranquillisation. Very few psychiatrists reported that their units had written guidelines.

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