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The Use of Antipsychotic Medications in the Emergency Department: a Narrative Review

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Abstract

Purpose of Review

Psychotic illness causes significant burdens of disease both domestically and globally. Antipsychotic medication is a cornerstone of treatment for psychosis. Long-term adherence to these medications has been shown to have a host of benefits to patients. One practice setting where the effects of scheduled antipsychotics have not been thoroughly explored is in the emergency department (ED).

Recent Findings

The use of antipsychotic medication for the management of acute agitation in the ED has been extensively studied. Droperidol and olanzapine appear to be more efficacious than other antipsychotic medications; however, they have similar efficacy to midazolam and ketamine. Antipsychotic use in the ED decreases the risk of violent events but is linked to increased lengths of stay.

Summary

Unfortunately, there is scant literature exploring the topic of initiating routine, scheduled antipsychotic medication for non-agitated patients in the ED. This represents a significant area for further research as EDs seek to determine best practices for this unique and vulnerable patient population.

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Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Authors and Affiliations

  1. Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA

    Sarah Van Remmen

  2. Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

    Gregory Jasani

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The entirety of this manuscript was co-written and co-edited by Drs. Van Remmen and Jasani.

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Correspondence to Sarah Van Remmen.

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Van Remmen, S., Jasani, G. The Use of Antipsychotic Medications in the Emergency Department: a Narrative Review. Curr Behav Neurosci Rep 10, 75–81 (2023). https://doi.org/10.1007/s40473-023-00263-6

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