Even if oral medications are preferred whenever their use is possible, intramuscular application (IM) of psychotropics is frequently needed in psychiatric emergencies. Benzodiazepine use has been recommended in recent guidelines as they have a lower incidence of side-effects, especially extrapyramidal symptoms, when compared with typical antipsychotics. Lorazepam has been the preferred benzodiazepine because of its reliable absorption; its parenteral formulation, however, is unavailable in Brazil. This probably explains the addition of promethazine, a sedative antihistamine, to haloperidol in our emergency rooms. This combination has the virtue of having been tested in several high quality randomized trials, with hundreds of patients exposed. The haloperidol-promethazine mix, however, has not been tested against the combination of an antipsychotic and benzodiazepine, which is standard practice, at least in countries where parenteral lorazepam is available.