Droperidol is safe and effective for the treatment of severely agitated patients in the ED [1-3]. But what about its use for agitation in elderly patients specifically? Droperidol Efficacy Two Australian studies evaluated droperidol in more than 200 older adults (≥ 65 years old) in the prehospital and ED settings [4,5]. Both studies found droperidol to be effective in elderly patients with acute behavioral disturbances. The median time to sedation was ~20-30 minutes with doses ranging from 2.5-10 mg (Table 1).  Characteristic Page, et al (n=162) Calver, et al (n=47) Median Age 78 years 81 years Initial Droperidol IM Dose 5 mg 10 mg (n=30) 5 mg (n=15) 2.5 mg (n=2) Median Time to Sedation 19 mins 10 mg: 30 mins 5 mg: 21 mins 2.5 mg: NA Patients Sedated with ≤ 10 mg Droperidol 144 (89%) 34 (72%) Table 1: Efficacy of droperidol in older adults Droperidol Safety Additionally, each study broke down each time a patient experienced an adverse event (Table 2). Overall, these adverse events were uncommon (4.5%), mild in nature, and resolved spontaneously or with minor interventions. No patients developed Torsades de Pointes.  Study Age/Sex Droperidol Dose Adverse Events Management Time Post-Droperidol Page, et al (n=162) 76 yo Male 5 mg SBP <90 (88/54) Spontaneous Resolution – 87 yo Female 10 mg SBP <90 (80/46) Spontaneous Resolution – 79 yo Female 5 mg SBP <90 (83/48) O2 sat <90% (80%) Supplemental Oxygen 500 mL IV Fluid – 82 yo Male 5 mg RR <12 (RR 10) Spontaneous Resolution – 86 yo Male 5 mg O2 sat <90% (88%) Supplemental Oxygen – Calver, et al (n=49) 75 yo Male 10 mg SBP <90 – 30 mins 68 yo Female 10 mg SBP … Continue reading Droperidol for Agitation in Older Adults in the Emergency Department