Emergency Medical Minute13 Juli

Podcast 1012: Meth Sedation

Contributor: Aaron Lessen, MD

Educational Pearls:

Agitated patients who are intoxicated with methamphetamine pose a unique challenge when selecting a sedative to counter their symptoms. Is there a superior medication?

A recent study compared the efficacy of commonly used medications for methamphetamine-induced agitation in the emergency department.

The study compared IM Droperidol 5mg, IM Olanzapine 10mg, IM Midazolam 5mg, and IM Lorazepam 2mg.
The study concluded that Droperidol, Olanzapine, and Midazolam performed similarly, with a median time to adequate sedation of 15 minutes.
Lorazepam took the longest, with a median time of 30 minutes to achieve adequate sedation.

Patients who received Lorazepam also required rescue medication more frequently after the initial dose.

Key takeaway: Droperidol, Olanzapine, and Midazolam may be more effective than Lorazepam for treating methamphetamine-induced agitation.

References:

Martel M, Klein LR, Cole JB, et al. Intramuscular droperidol, olanzapine, midazolam, or lorazepam to treat methamphetamine intoxication in the emergency department. Am J Emerg Med. 2021;49:142-148. doi:10.1016/j.ajem.2021.05.045

Summarized by Ashley Lyons, OMS4 | Edited by Ashley Lyons & Ahmed Abdel-Hafiz, NREMT-P

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