Why not use sedative antihistamines?
Because those who control RCTs control practice Given the powerful reasons for avoiding or minimizing patient exposure to neuroleptics, it would not be unreasonable to consider immediately substituting antihistamines for neuroleptics wherever possible, especially by an initial trial of sedating antihistamines for newly admitted acutely disturbed psychotic patients. Since traditional neuroleptics are the most powerful agents for suppressing agitated behavior, there may be rare situations in which their use is unavoidable. But the atypical neuroleptics can probably always be substituted by safer sedatives such as the benzodiazepines or antihistamines. Naturally, in the longer-term, the balance of benefits and harm between sedatives and neuroleptics would need to be quantified by formal clinical trials in various situations and patient groups. However, such a shift in practice however desirable from the perspective of patients can not and will not happen without the development of new pos
