Emergency drugs for severe agitation in the acute setting
What emergency medications should be considered for severe agitation in the acute setting?
A commonly used emergency treatment of agitation (sometimes called the B52 cocktail ) is a combination of diphenhydramine (Benadryl) 50 mg (for dystonia prophylaxis) per os or intramuscularly, haloperidol 5 mg, and lorazepam 2 mg.
Olanzapine 10 mg intramuscularly and other newer parenteral alternatives are also available.
Quetiapine or clozapine may be preferred in patients with Parkinson’s disease and delirium.
The doses suggested above should be decreased considerably for patients with increased sensitivity to psychotropics such as those with developmental disorders or brain injuries and the elderly.
