Pharmakotherapie von psychiatrischen Akut- und Notfallsituationen

Allgemeine Prinzipien

Pharmacotherapy of psychiatric acute and emergency situations

General principles

Der Nervenarzt volume 86, pages1097–1110(2015)Cite this article

Zusammenfassung

Die Pharmakotherapie psychiatrischer Notfallpatienten wird wesentlich von der Akuität, dem Notfallort, der diagnostischen Einschätzung und dem besonderen pharmakologischen Anforderungsprofil der eingesetzten Medikamente bestimmt. Da es keine spezifischen Medikamente gibt, erfolgt die Behandlung syndromal. Hierfür stehen vorrangig Antipsychotika und Benzodiazepine zur Verfügung. Der vorliegende Beitrag gibt einen Überblick über den aktuellen Stand der Behandlungsoptionen für die wichtigsten psychiatrischen Notfallsyndrome, nämlich Unruhezustände, Delir, Katatonie und Stupor, Angst und Panik sowie medikamentös-induzierte Notfälle.

Summary

The pharmacotherapy of psychiatric emergencies is essentially determined by the acuteness, the scene of the emergency, the diagnostic assessment and the special pharmacological profile of the drug used. As there are no specific drugs, syndromic treatment is carried out. For this, primarily antipsychotic drugs and benzodiazepines are available. This article gives an overview of the current state of treatment options for major psychiatric emergency syndromes, namely agitation, delirium, stupor and catatonia, anxiety and panic, as well as drug-induced emergencies.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

US$ 39.95

Tax calculation will be finalised during checkout.

Abb. 1

Literatur

  1. 1.

    TREC Collaborative Group (2003) Rapid tranquillisation for agitated patients in emergency psychiatric rooms: a randomised trial of midazolam versus haloperidol plus promethazine. BMJ 327:708–713

    Article  Google Scholar 

  2. 2.

    Ables AZ, Nagubilli R (2010) Prevention, recognition, and management of serotonin syndrome. Am Fam Physician 81:1139–1142

    PubMed  Google Scholar 

  3. 3.

    Alexander J, Tharyan P, Adams C et al (2004) Rapid tranquillisation of violent or agitated patients in a psychiatric emergency setting. Pragmatic randomised trial of intramuscular lorazepam v. haloperidol plus promethazine. Br J Psychiatry 185:63–69

    Article  PubMed  Google Scholar 

  4. 4.

    Allen MH, Currier GW (2004) Use of restraints and pharmacotherapy in academic psychiatric emergency services. Gen Hosp Psychiatry 26:42–49

    Article  PubMed  Google Scholar 

  5. 5.

    Asadollahi S, Heidari K, Hatamabadi H et al (2015) Efficacy and safety of valproic acid versus haloperidol in patients with acute agitation: results of a randomized, double-blind, parallel-group trial. Int Clin Psychopharmacol 30:142–150

    Article  PubMed  Google Scholar 

  6. 6.

    Babington PW, Spiegel DR (2007) Treatment of catatonia with olanzapine and amantadine. Psychosomatics 48:534–536

    CAS  Article  PubMed  Google Scholar 

  7. 7.

    Baldacara L, Sanches M, Cordeiro DC, Jackoswski AP (2011) Rapid tranquilization for agitated patients in emergency psychiatric rooms: a randomized trial of olanzapine, ziprasidone, haloperidol plus promethazine, haloperidol plus midazolam and haloperidol alone. Rev Bras Psiquiatr 33:30–39

    Article  PubMed  Google Scholar 

  8. 8.

    Barak Y, Mazeh D, Plopski I, Baruch Y (2006) Intramuscular ziprasidone treatment of acute psychotic agitation in elderly patients with schizophrenia. Am J Geriatr Psychiatry 14:629–633

    Article  PubMed  Google Scholar 

  9. 9.

    Barbee JG, Mancuso DM, Freed CR, Todorov AA (1992) Alprazolam as a neuroleptic adjunct in the emergency treatment of schizophrenia. Am J Psychiatry 149:506–510

    CAS  Article  PubMed  Google Scholar 

  10. 10.

    Bartels SJ, Horn SD, Smout RJ et al (2003) Agitation and depression in frail nursing home elderly patients with dementia: treatment characteristics and service use. Am J Geriatr Psychiatry 11:231–238

    Article  PubMed  Google Scholar 

  11. 11.

    Battaglia J (2005) Pharmacological management of acute agitation. Drugs 65:1207–1222

    CAS  Article  PubMed  Google Scholar 

  12. 12.

    Battaglia J, Moss S, Rush J et al (1997) Haloperidol, lorazepam, or both for psychotic agitation? A multicenter, prospective, double-blind, emergency department study. Am J Emerg Med 15:335–340

    CAS  Article  PubMed  Google Scholar 

  13. 13.

    Belgamwar RB, Fenton M (2005) Olanzapine IM or velotab for acutely disturbed/agitated people with suspected serious mental illnesses. Cochrane Database Syst Rev:CD003729

    Google Scholar 

  14. 14.

    Belvederi Murri M, Guaglianone A, Bugliani M et al (2015) Second-generation antipsychotics and neuroleptic malignant syndrome: systematic review and case report analysis. Drugs R D 15:45–62

    Article  Google Scholar 

  15. 15.

    Bieniek SA, Ownby RL, Penalver A, Dominguez RA (1998) A double-blind study of lorazepam versus the combination of haloperidol and lorazepam in managing agitation. Pharmacotherapy 18:57–62

    CAS  PubMed  Google Scholar 

  16. 16.

    Breier A, Meehan K, Birkett M et al (2002) A double-blind, placebo-controlled dose-response comparison of intramuscular olanzapine and haloperidol in the treatment of acute agitation in schizophrenia. Arch Gen Psychiatry 59:441–448

    CAS  Article  PubMed  Google Scholar 

  17. 17.

    Carroll BT, Goforth HW, Thomas C et al (2007) Review of adjunctive glutamate antagonist therapy in the treatment of catatonic syndromes. J Neuropsychiatry Clin Neurosci 19:406–412

    CAS  Article  PubMed  Google Scholar 

  18. 18.

    Cavallazzi R, Saad M, Marik PE (2012) Delirium in the ICU: an overview: Ann Intensive Care 2:49

  19. 19.

    Chan EW, Taylor DM, Knott JC et al (2013) Intravenous droperidol or olanzapine as an adjunct to midazolam for the acutely agitated patient: a multicenter, randomized, double-blind, placebo-controlled clinical trial. Ann Emerg Med 61:72–81

    Article  PubMed  Google Scholar 

  20. 20.

    Citrome L (2007) Comparison of intramuscular ziprasidone, olanzapine, or aripiprazole for agitation: a quantitative review of efficacy and safety. J Clin Psychiatry 68:1876–1885

    CAS  Article  PubMed  Google Scholar 

  21. 21.

    Citrome L (2012) Inhaled loxapine for agitation revisited: focus on effect sizes from 2 Phase III randomised controlled trials in persons with schizophrenia or bipolar disorder. Int J Clin Pract 66:318–325

    CAS  Article  PubMed  Google Scholar 

  22. 22.

    Citrome L, Volavka J, Czobor P et al (2006) Efficacy of ziprasidone against hostility in schizophrenia: post hoc analysis of randomized, open-label study data. J Clin Psychiatry 67:638–642

    CAS  Article  PubMed  Google Scholar 

  23. 23.

    Crowner ML, Peric G, Stepcic F, Lee S (2005) Assailant and victim behaviors immediately preceding inpatient assault. Psychiatr Q 76:243–256

    Article  PubMed  Google Scholar 

  24. 24.

    Currier GW, Chou JC, Feifel D et al (2004) Acute treatment of psychotic agitation: a randomized comparison of oral treatment with risperidone and lorazepam versus intramuscular treatment with haloperidol and lorazepam. J Clin Psychiatry 65:386–394

    CAS  Article  PubMed  Google Scholar 

  25. 25.

    De Fruyt J, Demyttenaere K (2004) Rapid tranquilization: new approaches in the emergency treatment of behavioral disturbances. Eur Psychiatry 19:243–249

    Article  Google Scholar 

  26. 26.

    Di Salvo TG, O’Gara PT (1995) Torsade de pointes caused by high-dose intravenous haloperidol in cardiac patients. Clin Cardiol 18:285–290

    Article  Google Scholar 

  27. 27.

    Dorevitch A, Katz N, Zemishlany Z et al (1999) Intramuscular flunitrazepam versus intramuscular haloperidol in the emergency treatment of aggressive psychotic behavior. Am J Psychiatry 156:142–144

    CAS  Article  PubMed  Google Scholar 

  28. 28.

    Dosi R, Ambaliya A, Joshi H, Patell R (2014) Serotonin syndrome versus neuroleptic malignant syndrome: a challenging clinical quandary. BMJ Case Rep 2014

  29. 29.

    Foster S, Kessel J, Berman ME, Simpson GM (1997) Efficacy of lorazepam and haloperidol for rapid tranquilization in a psychiatric emergency room setting. Int Clin Psychopharmacol 12:175–179

    CAS  Article  PubMed  Google Scholar 

  30. 30.

    Frucht SJ (2014) Treatment of movement disorder emergencies. Neurotherapeutics 11:208–212

    PubMed Central  Article  PubMed  Google Scholar 

  31. 31.

    Garza-Trevino ES, Hollister LE, Overall JE, Alexander WF (1989) Efficacy of combinations of intramuscular antipsychotics and sedative-hypnotics for control of psychotic agitation: Am J Psychiatry 146:1598–1601

  32. 32.

    Gillman PK (2010) Neuroleptic malignant syndrome: mechanisms, interactions, and causality. Mov Disord 25:1780–1790

    Article  PubMed  Google Scholar 

  33. 33.

    Goedhard LE, Stolker JJ, Heerdink ER et al (2006) Pharmacotherapy for the treatment of aggressive behavior in general adult psychiatry: a systematic review. J Clin Psychiatry 67:1013–1024

    CAS  Article  PubMed  Google Scholar 

  34. 34.

    Gortney JS, Fagan A, Kissack JC (2009) Neuroleptic malignant syndrome secondary to quetiapine. Ann Pharmacother 43:785–791

    CAS  Article  PubMed  Google Scholar 

  35. 35.

    Grover S, Kumar V, Chakrabarti S (2011) Comparative efficacy study of haloperidol, olanzapine and risperidone in delirium. J Psychosom Res 71:277–281

    Article  PubMed  Google Scholar 

  36. 36.

    Han CS, Kim YK (2004) A double-blind trial of risperidone and haloperidol for the treatment of delirium. Psychosomatics 45:297–301

    CAS  Article  PubMed  Google Scholar 

  37. 37.

    Hatta K, Takahashi T, Nakamura H et al (2001) The association between intravenous haloperidol and prolonged QT interval. J Clin Psychopharmacol 21:257–261

    CAS  Article  PubMed  Google Scholar 

  38. 38.

    Hovens JE, Dries PJ, Melman CT et al (2005) Oral risperidone with lorazepam versus oral zuclopenthixol with lorazepam in the treatment of acute psychosis in emergency psychiatry: a prospective, comparative, open-label study. J Psychopharmacol 19:51–57

    CAS  Article  PubMed  Google Scholar 

  39. 39.

    Huband N, Ferriter M, Nathan R, Jones H (2010) Antiepileptics for aggression and associated impulsivity. Cochrane Database Syst Rev:CD003499

    Google Scholar 

  40. 40.

    Huf G, Alexander J, Allen MH, Raveendran NS (2009) Haloperidol plus promethazine for psychosis-induced aggression. Cochrane Database Syst Rev:CD005146

    Google Scholar 

  41. 41.

    Jones RM, Arlidge J, Gillham R et al (2011) Efficacy of mood stabilisers in the treatment of impulsive or repetitive aggression: systematic review and meta-analysis. Br J Psychiatry 198:93–98

    Article  PubMed  Google Scholar 

  42. 42.

    Kim SW, Yoo JA, Lee SY et al (2010) Risperidone versus olanzapine for the treatment of delirium. Hum Psychopharmacol 25:298–302

    CAS  Article  PubMed  Google Scholar 

  43. 43.

    Kinon BJ, Stauffer VL, Kollack-Walker S et al (2008) Olanzapine versus aripiprazole for the treatment of agitation in acutely ill patients with schizophrenia. J Clin Psychopharmacol 28:601–607

    CAS  Article  PubMed  Google Scholar 

  44. 44.

    Kirino E (2010) Prolonged catatonic stupor successfully treated with aripiprazole in an adolescent male with schizophrenia: a case report. Clin Schizophr Relat Psychoses 4:185–188

    Article  PubMed  Google Scholar 

  45. 45.

    Knott JC, Taylor DM, Castle DJ (2006) Randomized clinical trial comparing intravenous midazolam and droperidol for sedation of the acutely agitated patient in the emergency department. Ann Emerg Med 47:61–67

    Article  PubMed  Google Scholar 

  46. 46.

    Kropp S, Andreis C, te Wildt B et al (2007) Characteristics of psychiatric patients in the accident and emergency department (ED). Psychiatr Prax 34:72–75

    Article  PubMed  Google Scholar 

  47. 47.

    Kwentus J, Riesenberg RA, Marandi M et al (2012) Rapid acute treatment of agitation in patients with bipolar I disorder: a multicenter, randomized, placebo-controlled clinical trial with inhaled loxapine. Bipolar Disord 14:31–40

    CAS  Article  PubMed  Google Scholar 

  48. 48.

    Lee KU, Won WY, Lee HK et al (2005) Amisulpride versus quetiapine for the treatment of delirium: a randomized, open prospective study. Int Clin Psychopharmacol 20:311–314

    Article  PubMed  Google Scholar 

  49. 49.

    Lesem MD, Tran-Johnson TK, Riesenberg RA et al (2011) Rapid acute treatment of agitation in individuals with schizophrenia: multicentre, randomised, placebo-controlled study of inhaled loxapine. Br J Psychiatry 198:51–58

    Article  PubMed  Google Scholar 

  50. 50.

    Lonergan E, Britton AM, Luxenberg J, Wyller T (2007) Antipsychotics for delirium. Cochrane Database Syst Rev:CD005594

    Google Scholar 

  51. 51.

    Lonergan E, Luxenberg J (2009) Valproate preparations for agitation in dementia. Cochrane Database Syst Rev:CD003945

    Google Scholar 

  52. 52.

    Marco CA, Vaughan J (2005) Emergency management of agitation in schizophrenia. Am J Emerg Med 23:767–776

    Article  PubMed  Google Scholar 

  53. 53.

    Moscovich M, Novak FT, Fernandes AF et al (2011) Neuroleptic malignant syndrome. Arq Neuropsiquiatr 69:751–755

    Article  PubMed  Google Scholar 

  54. 54.

    Munhoz RP, Moscovich M, Araujo PD, Teive HA (2012) Movement disorders emergencies: a review. Arq Neuropsiquiatr 70:453–461

    Article  PubMed  Google Scholar 

  55. 55.

    Musshoff F, Doberentz E, Madea B (2013) Lethal neuroleptic malignant syndrome due to amisulpride. Forensic Sci Med Pathol 9:218–220

    Article  PubMed  Google Scholar 

  56. 56.

    Owen C, Tarantello C, Jones M, Tennant C (1998) Violence and aggression in psychiatric units. Psychiatr Serv 49:1452–1457

    CAS  Article  PubMed  Google Scholar 

  57. 57.

    Pajonk FG, Schmitt P, Biedler A et al (2008) Psychiatric emergencies in prehospital emergency medical systems: a prospective comparison of two urban settings. Gen Hosp Psychiatry 30:360–366

    Article  PubMed  Google Scholar 

  58. 58.

    Pascual JC, Madre M, Soler J et al (2006b) Injectable atypical antipsychotics for agitation in borderline personality disorder. Pharmacopsychiatry 39:117–118

    CAS  Article  PubMed  Google Scholar 

  59. 59.

    Patra BN, Khandelwal SK, Sood M (2013) Olanzapine induced neuroleptic malignant syndrome. Indian J Pharmacol 45:98–99

    PubMed Central  Article  PubMed  Google Scholar 

  60. 60.

    Pelland C, Trudel JF (2009) Atypical antipsychotic efficacy and safety in managing delirium: a systematic review and critical analysis. Psychol Neuropsychiatr Vieil 7:109–119

    PubMed  Google Scholar 

  61. 61.

    Peralta V, Campos MS, Jalon EG de, Cuesta MJ (2010) DSM-IV catatonia signs and criteria in first-episode, drug-naive, psychotic patients: psychometric validity and response to antipsychotic medication. Schizophr Res 118:168–175

    Article  PubMed  Google Scholar 

  62. 62.

    Perry PJ, Wilborn CA (2012) Serotonin syndrome vs neuroleptic malignant syndrome: a contrast of causes, diagnoses, and management. Ann Clin Psychiatry 24:155–162

    PubMed  Google Scholar 

  63. 63.

    Powell G, Caan W, Crowe M (1994) What events precede violent incidents in psychiatric hospitals? Br J Psychiatry 165:107–112

    CAS  Article  PubMed  Google Scholar 

  64. 64.

    Pratts M, Citrome L, Grant W et al (2014) A single-dose, randomized, double-blind, placebo-controlled trial of sublingual asenapine for acute agitation. Acta Psychiatr Scand 130:61–68

    CAS  Article  PubMed  Google Scholar 

  65. 65.

    Puffer E, Messer T, Pajonk FG (2012) Psychiatric care in emergency departments. Anaesthesist 61:215–223

    CAS  Article  PubMed  Google Scholar 

  66. 66.

    Raveendran NS, Tharyan P, Alexander J, Adams CE (2007) Rapid tranquillisation in psychiatric emergency settings in India: pragmatic randomised controlled trial of intramuscular olanzapine versus intramuscular haloperidol plus promethazine. BMJ 335:865

    PubMed Central  CAS  Article  PubMed  Google Scholar 

  67. 67.

    Rocca P, Villari V, Bogetto F (2006) Managing the aggressive and violent patient in the psychiatric emergency. Prog Neuropsychopharmacol Biol Psychiatry 30:586–598

    Article  PubMed  Google Scholar 

  68. 68.

    Rortgen D, Schaumberg A, Skorning M et al (2011) Stocked medications in emergency physician-based medical services in Germany. Reality and requirements according to guidelines. Anaesthesist 60:312–324

    CAS  Article  PubMed  Google Scholar 

  69. 69.

    Satterthwaite TD, Wolf DH, Rosenheck RA et al (2008) A meta-analysis of the risk of acute extrapyramidal symptoms with intramuscular antipsychotics for the treatment of agitation. J Clin Psychiatry 69:1869–1879

    PubMed Central  CAS  Article  PubMed  Google Scholar 

  70. 70.

    Schwerthöffer D, Beuys D, Hamann J et al (2015) Versorgung psychiatrischer Notfälle in psychiatrischen Kliniken in Deutschland. Psychiatr Prax. DOI 10.1055/s-0034-1387644

  71. 71.

    Seitz DP, Adunuri N, Gill SS et al (2011) Antidepressants for agitation and psychosis in dementia. Cochrane Database Syst Rev:CD008191

    Google Scholar 

  72. 72.

    Skrobik YK, Bergeron N, Dumont M, Gottfried SB (2004) Olanzapine vs haloperidol: treating delirium in a critical care setting. Intensive Care Med 30:444–449

    Article  PubMed  Google Scholar 

  73. 73.

    Strawn JR, Keck PE Jr, Caroff SN (2007) Neuroleptic malignant syndrome. Am J Psychiatry 164:870–876

    Article  PubMed  Google Scholar 

  74. 74.

    Tardiff K, Sweillam A (1982) Assaultive behavior among chronic inpatients. Am J Psychiatry 139:212–215

    CAS  Article  PubMed  Google Scholar 

  75. 75.

    Trollor JN, Chen X, Chitty K, Sachdev PS (2012) Comparison of neuroleptic malignant syndrome induced by first- and second-generation antipsychotics. Br J Psychiatry 201:52–56

    Article  PubMed  Google Scholar 

  76. 76.

    Trollor JN, Sachdev PS (1999) Electroconvulsive treatment of neuroleptic malignant syndrome: a review and report of cases. Aust N Z J Psychiatry 33:650–659

    CAS  Article  PubMed  Google Scholar 

  77. 77.

    Uguz F, Sonmez EO (2013) Neuroleptic malignant syndrome following combination of sertraline and paroxetine: a case report. Gen Hosp Psychiatry 35:327

    Article  PubMed  Google Scholar 

  78. 78.

    Vieweg WV, Wood MA, Fernandez A et al (2009) Proarrhythmic risk with antipsychotic and antidepressant drugs: implications in the elderly. Drugs Aging 26:997–1012

    CAS  Article  PubMed  Google Scholar 

  79. 79.

    Villari V, Rocca P, Fonzo V et al (2008) Oral risperidone, olanzapine and quetiapine versus haloperidol in psychotic agitation. Prog Neuropsychopharmacol Biol Psychiatry 32:405–413

    CAS  Article  PubMed  Google Scholar 

  80. 80.

    Wagstaff AJ, Easton J, Scott LJ (2005) Intramuscular olanzapine: a review of its use in the management of acute agitation. CNS Drugs 19:147–164

    CAS  Article  PubMed  Google Scholar 

  81. 81.

    Wang HR, Woo YS, Bahk WM (2013) Atypical antipsychotics in the treatment of delirium. Psychiatry Clin Neurosci 67:323–331

    CAS  Article  PubMed  Google Scholar 

  82. 82.

    Wang Y, He R, Zhang H (2012) Case report on clozapine-associated neuroleptic malignant syndrome. Shanghai Arch Psychiatry 24:116–117

    PubMed Central  CAS  PubMed  Google Scholar 

  83. 83.

    Wilson MP, MacDonald K, Vilke GM, Feifel D (2012) A comparison of the safety of olanzapine and haloperidol in combination with benzodiazepines in emergency department patients with acute agitation. J Emerg Med 43:790–797

    Article  PubMed  Google Scholar 

  84. 84.

    Wilson MP, Minassian A, Bahramzi M et al (2014) Despite expert recommendations, second-generation antipsychotics are not often prescribed in the emergency department. J Emerg Med 46:808–813

    Article  PubMed  Google Scholar 

  85. 85.

    Wilson MP, Pepper D, Currier GW et al (2012) The psychopharmacology of agitation: consensus statement of the american association for emergency psychiatry project Beta psychopharmacology workgroup. West J Emerg Med 13:26–34

    PubMed Central  Article  PubMed  Google Scholar 

  86. 86.

    Wright P, Birkett M, David SR et al (2001) Double-blind, placebo-controlled comparison of intramuscular olanzapine and intramuscular haloperidol in the treatment of acute agitation in schizophrenia. Am J Psychiatry 158:1149–1151

    CAS  Article  PubMed  Google Scholar 

  87. 87.

    Zeller SL, Rhoades RW (2010) Systematic reviews of assessment measures and pharmacologic treatments for agitation. Clin Ther 32:403–425

    CAS  Article  PubMed  Google Scholar 

  88. 88.

    Zisselman MH, Jaffe RL (2010) ECT in the treatment of a patient with catatonia: consent and complications. Am J Psychiatry 167:127–132

    Article  PubMed  Google Scholar 

Download references

Einhaltung ethischer Richtlinien

Interessenkonflikt. T. Messer für das Jahr 2014: Vortragshonorare und finanzielle Unterstützung bei Kongressen: Lundbeck GmbH, Otsuka, Janssen-Cilag, Trommsdorff. F.-G. Pajonk hat in den letzten 3 Jahren die Fa. Trommsdorff beratend unterstützt und hat bezahlte Vorträge mit Unterstützung der Fa. Trommsdorff gehalten. M.J. Müller hat Reisekostenerstattungen für wissenschaftliche Tagungen, Kongresse oder Fortbildungsveranstaltungen von Servier, Lilly, Lundbeck, Janssen-Cilag und Merz Pharma erhalten, war in einem Advisory Board von Lundbeck, ist im Besitz von Aktien der Firma Novartis und hat Vortragshonorare von Servier und Janssen-Cilag erhalten.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Author information

Affiliations

  1. Danuvius Klinik GmbH, Krankenhausstr. 68, 85276, Pfaffenhofen an der Ilm, Deutschland

    PD Dr. T. Messer

  2. Praxis Isartal, Kloster Schäftlarn, Deutschland

    F.-G. Pajonk

  3. Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland

    F.-G. Pajonk

  4. Vitos Klinikum Gießen-Marburg, Marburg, Deutschland

    M.J. Müller

Authors
  1. PD Dr. T. Messer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F.-G. Pajonk
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M.J. Müller
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to PD Dr. T. Messer.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Messer, T., Pajonk, FG. & Müller, M. Pharmakotherapie von psychiatrischen Akut- und Notfallsituationen. Nervenarzt 86, 1097–1110 (2015). https://doi.org/10.1007/s00115-014-4148-x

Download citation

Schlüsselwörter

  • Notfallmedizin
  • Notfallpsychiatrie
  • Psychopharmaka
  • Verabreichung und Dosierung
  • Medikamentenbezogene Begleiterscheinungen und Nebenwirkungen

Keywords

  • Emergency medicine
  • Emergency psychiatry
  • Psychotropic drugs
  • Administration and dosage
  • Drug-related side effects and adverse reactions