Oral risperidone plus oral lorazepam versus standard care with intramuscular conventional neuroleptics in the initial phase of treating individuals with acute psychosis
| Autor: | Rossella Medori, Joseph Lejeune, Roel Witte, Ilkka Larmo, Andreas Schreiner, Alice Lex, Athanasios Karavatos, Wlodzimierz Chrzanowski |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male Adolescent medicine.drug_class Administration Oral Lorazepam Injections Intramuscular Hypnotic Basal Ganglia Diseases Extrapyramidal symptoms Oral administration mental disorders medicine Humans Hypnotics and Sedatives Pharmacology (medical) Aged Aged 80 and over Risperidone Dose-Response Relationship Drug business.industry Dopamine antagonist Middle Aged medicine.disease Aggression Psychiatry and Mental health Treatment Outcome Psychotic Disorders Schizophrenia Anesthesia Sedative Acute Disease Drug Therapy Combination Female medicine.symptom business Antipsychotic Agents medicine.drug |
| Zdroj: | International Clinical Psychopharmacology. 19:259-269 |
| ISSN: | 0268-1315 |
| DOI: | 10.1097/01.yic.0000138820.78121.0e |
| Popis: | Although atypical antipsychotics are now considered first line treatments for schizophrenia, intramuscular (i.m.) conventional neuroleptics are often still considered necessary in emergency treatment of acute psychoses. This European, multicentre, open-label, active-controlled trial compared oral risperidone plus oral lorazepam to standard care with i.m. conventional neuroleptics with or without lorazepam in the emergency treatment of acutely psychotic patients. Patients were allowed to choose either oral risperidone (a single dose of 2 mg and 2.0-2.5 mg lorazepam; 121 patients) or standard i.m. treatment (conventional neuroleptic with or without lorazepam; 105 patients). No additional treatment was allowed for 2 h. Primary outcome was the percentage of patients with treatment success (asleep or at least much improved on Clinical Global Impression-global improvement scale) 2 h after treatment initiation. Baseline characteristics were similar in both treatment groups. Oral risperidone plus oral lorazepam was more successful at 2 h (66.9%) and significantly non-inferior compared to standard i.m. care (54.3%; P=0.0003), and the incidence of extrapyramidal symptoms (EPS) was lower (1.7%) compared to standard i.m. care (9.5%). In acutely psychotic patients requiring emergency treatment, oral risperidone/oral lorazepam was at least as effective as i.m. conventional neuroleptic treatment with or without lorazepam. Oral risperidone plus lorazepam rapidly reduces symptoms, including aggression, and causes fewer EPS. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|