The pharmacological management of agitated and aggressive behaviour: A systematic review and meta-analysis

Autor: Przemyslaw Bienkowski, Błażej Misiak, Marjan Drukker, Jerzy Samochowiec, Dorota Frydecka, Gaia Sampogna, Agnieszka Samochowiec, Emma Bak, Maarten Bak, Geert Dom, Irene Weltens, Andrea Fiorillo, Jürgen De Fruyt, W. Ulrich Preuss, Chris Bervoets
Přispěvatelé: Bak, M., Weltens, I., Bervoets, C., De Fruyt, J., Samochowiec, J., Fiorillo, A., Sampogna, G., Bienkowski, P., Preuss, W. U., Misiak, B., Frydecka, D., Samochowiec, A., Bak, E., Drukker, M., Dom, G.
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Olanzapine
Hypnotics and Sedative
Poison control
Promethazine
law.invention
IM ZIPRASIDONE
Halperidol
DOUBLE-BLIND
Benzodiazepines
Randomized controlled trial
law
Haloperidol
Hypnotics and Sedatives
PANNS-EC
Psychomotor Agitation
Psychiatry
Benzodiazepine
PLACEBO
Lorazepam
RANDOMIZED CONTROLLED-TRIAL
RISPERIDONE ORAL SOLUTION
RAPID ACUTE TREATMENT
Agression
Aggression
Psychiatry and Mental health
Treatment Outcome
Drug Therapy
Combination
Droperidol
Life Sciences & Biomedicine
medicine.drug
Antipsychotic Agents
Human
medicine.medical_specialty
INTRAMUSCULAR OLANZAPINE
Midazolam
V. HALOPERIDOL
Rapid tranquillisation
Psychotic Disorder
Anti-Anxiety Agent
medicine
Humans
Adverse effect
Agitation
Science & Technology
business.industry
Antipsychotic Agent
Anti-Anxiety Agents
Psychotic Disorders
EMERGENCY PSYCHIATRIC ROOMS
Emergency medicine
Human medicine
business
PSYCHOTIC AGITATION
Zdroj: European psychiatry
ISSN: 0924-9338
Popis: Introduction:Non-pharmacological interventions preferably precede pharmacological interventions in acute agitation. Reviews of pharmacological interventions remain descriptive or compare only one compound with several other compounds. The goal of this study is to compute a systematic review and meta-analysis of the effect on restoring calmness after a pharmacological intervention, so a more precise recommendation is possible.Method:A search in Pubmed and Embase was done to isolate RCT’s considering pharmacological interventions in acute agitation. The outcome is reaching calmness within maximum of 2 h, assessed by the psychometric scales of PANSS-EC, CGI or ACES. Also the percentages of adverse effects was assessed.Results:Fifty-three papers were included for a systematic review and meta-analysis. Most frequent studied drug is olanzapine. Changes on PANNS-EC and ACES at 2 h showed the strongest changes for haloperidol plus promethazine, risperidon, olanzapine, droperidol and aripiprazole. However, incomplete data showed that the effect of risperidon is overestimated. Adverse effects are most prominent for haloperidol and haloperidol plus lorazepam.Conclusion:Olanzapine, haloperidol plus promethazine or droperidol are most effective and safe for use as rapid tranquilisation. Midazolam sedates most quickly. But due to increased saturation problems, midazolam is restricted to use within an emergency department of a general hospital.
Databáze: OpenAIRE
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