Pharmacological Control of Acute Agitation
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Acute agitation in the psychiatric emergency setting is a common presentation, which can endanger the patient, caregivers and professional staff. Rapid and effective treatment, followed by ongoing evaluation and maintenance treatment where appropriate, is key to circumvent negative outcomes. Nonpharmacological measures are the first step in treating the acutely agitated patient, and include verbal intervention and physical restraint. Pharmacological treatment is often required to ensure the safety of the patient, caregivers and the treatment team. The need for drug delivery in uncooperative patients favours the use of intramuscular preparations for the acutely agitated patient. Intramuscular treatment options include benzodiazepines, conventional antipsychotics and atypical antipsychotics. Each of these medications offers a unique pharmacological profile that must be considered when treating acutely agitated patients, who may be unwilling or unable to accurately communicate their co-morbid conditions and concomitant medications.
KeywordsHaloperidol Olanzapine Aripiprazole Atypical Antipsychotic Ziprasidone
Editorial support was provided by Annie Neild at PAREXEL, funding for which was provided by Pfizer Inc. Dr Zimbroff has received consultancy fees from Pfizer, Bristol Myers Squibb (BMS) and Eli Lilly & Co; received honoraria for speaking for Pfizer and BMS; received research study grants from Pfizer, Eli Lilly & Co. and BMS; and, in conjunction with his research activities, has received payments from Pfizer, Eli Lilly & Co. and BMS.
Unfortunately, Dr Zimbroff passed away before the page proofs were available; therefore, in the absence of a co-author, Annie Neild of PAREXEL and Elizabeth Pappadopulos of Pfizer Inc. approved the proofs for publication.
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