Geodon vs Haldol?

[Zback]

Why pick one versus the other? I know they talk about prolonged QT with Geodon. I saw a resident use Geodon to control a aggressive/threatening patient and wondered what the benefit of using it was versus Haldol, but I forgot to ask him.

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[jdh71]

Why pick one versus the other? I know they talk about prolonged QT with Geodon. I saw a resident use Geodon to control a aggressive/threatening patient and wondered what the benefit of using it was versus Haldol, but I forgot to ask him.

All antipsychotics prolong QT. Geo probably does it the worst. Which is probably too bad because it works really well for agitation. QT prolongation leadung to an arrhythmia isn't going to be a common phenomenon but its not exactly rare either, so many docs have decided against using geodon and instead use others defensively. Most people will also use the meds they were trained with because they have a context for its use in a predictable fashion.

 

[goodoldalky]

Anecdotally patients seem less snowed with geodon than haloperidol, however the QT effect is worse. For that reason alone I'd stick with haloperidol or droperidol personally.

 

[turkeyjerky]

Oftentimes the particular agent used depends on which one is en vogue at that place and which one they have in the Pyxis. Ziprasidone does take longer to work than haloperidol or droperidol (which is fastest and probably the best). Multimodal sedation using benzos and antipsychotics is def better than using either alone. Regarding BZDs, a frequent mistake is to use Ativan rather than versed which is faster acting and has a shorter duration of action.