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Midazolam vs. diphenhydramine for the treatment of metoclopramide-induced akathisia: a randomized controlled trial.
Acad Emerg Med. 2007 Aug; 14(8):715-21.AE

Abstract

OBJECTIVES

To compare the effects of midazolam, which is a fast and short-acting benzodiazepine, and diphenhydramine, which is a widely used anticholinergic agent, in clinical practice for the treatment of metoclopramide-induced akathisia.

METHODS

All adults older than 17 years given metoclopramide for nausea and vomiting or for headache and who had akathisia were eligible for this clinical, randomized, double-blind trial. Patients were randomized to receive diphenhydramine or midazolam. Subjective, objective, and total akathisia scores and modified Ramsay Sedation Scale scores were recorded. Repeated-measures analysis of variance was used to compare the efficacy and side effects of the medications.

RESULTS

Forty-one (73.3%) of the 56 enrolled patients were women. The mean (+/-SD) age was 39.9 (+/-15.7) years in the diphenhydramine group and 40.9 (+/-16.2) years in the midazolam group. Mean subjective, objective, and total akathisia scores in the first 5 minutes declined considerably in the midazolam group compared with the diphenhydramine group (p < 0.001). However, the mean Ramsay Sedation Scale score in the first 15 minutes increased significantly in the midazolam group compared with the diphenhydramine group (p < 0.001).

CONCLUSIONS

Midazolam can correct the symptoms of metoclopramide-induced akathisia faster than diphenhydramine, but it causes more sedation.

Authors+Show Affiliations

Department of Emergency Medicine, Dokuz Eylul University, Izmir, Turkey.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17545174

Citation

Parlak, Ismet, et al. "Midazolam Vs. Diphenhydramine for the Treatment of Metoclopramide-induced Akathisia: a Randomized Controlled Trial." Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, vol. 14, no. 8, 2007, pp. 715-21.
Parlak I, Erdur B, Parlak M, et al. Midazolam vs. diphenhydramine for the treatment of metoclopramide-induced akathisia: a randomized controlled trial. Acad Emerg Med. 2007;14(8):715-21.
Parlak, I., Erdur, B., Parlak, M., Ergin, A., Ayrik, C., Tomruk, O., Turkcuer, I., & Ergin, N. (2007). Midazolam vs. diphenhydramine for the treatment of metoclopramide-induced akathisia: a randomized controlled trial. Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, 14(8), 715-21.
Parlak I, et al. Midazolam Vs. Diphenhydramine for the Treatment of Metoclopramide-induced Akathisia: a Randomized Controlled Trial. Acad Emerg Med. 2007;14(8):715-21. PubMed PMID: 17545174.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Midazolam vs. diphenhydramine for the treatment of metoclopramide-induced akathisia: a randomized controlled trial. AU - Parlak,Ismet, AU - Erdur,Bulent, AU - Parlak,Mine, AU - Ergin,Ahmet, AU - Ayrik,Cuneyt, AU - Tomruk,Onder, AU - Turkcuer,Ibrahim, AU - Ergin,Nesrin, Y1 - 2007/05/31/ PY - 2007/6/5/pubmed PY - 2007/9/12/medline PY - 2007/6/5/entrez SP - 715 EP - 21 JF - Academic emergency medicine : official journal of the Society for Academic Emergency Medicine JO - Acad Emerg Med VL - 14 IS - 8 N2 - OBJECTIVES: To compare the effects of midazolam, which is a fast and short-acting benzodiazepine, and diphenhydramine, which is a widely used anticholinergic agent, in clinical practice for the treatment of metoclopramide-induced akathisia. METHODS: All adults older than 17 years given metoclopramide for nausea and vomiting or for headache and who had akathisia were eligible for this clinical, randomized, double-blind trial. Patients were randomized to receive diphenhydramine or midazolam. Subjective, objective, and total akathisia scores and modified Ramsay Sedation Scale scores were recorded. Repeated-measures analysis of variance was used to compare the efficacy and side effects of the medications. RESULTS: Forty-one (73.3%) of the 56 enrolled patients were women. The mean (+/-SD) age was 39.9 (+/-15.7) years in the diphenhydramine group and 40.9 (+/-16.2) years in the midazolam group. Mean subjective, objective, and total akathisia scores in the first 5 minutes declined considerably in the midazolam group compared with the diphenhydramine group (p < 0.001). However, the mean Ramsay Sedation Scale score in the first 15 minutes increased significantly in the midazolam group compared with the diphenhydramine group (p < 0.001). CONCLUSIONS: Midazolam can correct the symptoms of metoclopramide-induced akathisia faster than diphenhydramine, but it causes more sedation. SN - 1553-2712 UR - https://www.unboundmedicine.com/medline/citation/17545174/Midazolam_vs__diphenhydramine_for_the_treatment_of_metoclopramide_induced_akathisia:_a_randomized_controlled_trial_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=1069-6563&amp;date=2007&amp;volume=14&amp;issue=8&amp;spage=715 DB - PRIME DP - Unbound Medicine ER -