New treatments for agitation

被引:23
作者
Citrome, L
机构
[1] Nathan S Kline Inst Psychiat Res, Orangeburg, NY 10962 USA
[2] NYU, New York, NY USA
关键词
agitation; aggression; antipsychotics;
D O I
10.1023/B:PSAQ.0000031791.53142.85
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Acute agitation is a frequent reason for emergency psychiatric intervention. It is important to intervene early to avoid escalation of agitation to aggression. Reducing risk by using effective treatments will result in fewer instances of seclusion and restraint, and fewer injuries to staff and patients. This paper will first review the epidemiology of aggressive behavior and mental disorders, followed by a discussion of assessment and diagnostic considerations. The pathophysiology of safety risk is discussed within the context of the model of the "triune brain." Pharmacological treatment strategies for acute episodes of agitated behavior will be discussed in detail. This includes newer formulations of novel antipsychotics such as liquids and rapidly disintegrating tablets, as well as intramuscular preparations.
引用
收藏
页码:197 / 213
页数:17
相关论文
共 48 条
[31]   TRIUNE BRAIN IN CONFLICT [J].
MACLEAN, PD .
PSYCHOTHERAPY AND PSYCHOSOMATICS, 1977, 28 (1-4) :207-220
[32]  
MACLEAN PD, 1985, ARCH GEN PSYCHIAT, V42, P405
[33]   EVOLUTIONARY PSYCHIATRY AND THE TRIUNE BRAIN [J].
MACLEAN, PD .
PSYCHOLOGICAL MEDICINE, 1985, 15 (02) :219-221
[34]   A double-blind, randomized comparison of the efficacy and safety of intramuscular injections of olanzapine, lorazepam, or placebo in treating acutely agitated patients diagnosed with bipolar mania [J].
Meehan, K ;
Zhang, F ;
David, S ;
Tohen, M ;
Janicak, P ;
Small, J ;
Koch, K ;
Rizk, R ;
Walker, D ;
Tran, P ;
Breier, A .
JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY, 2001, 21 (04) :389-397
[35]   Comparison of rapidly acting intramuscular olanzapine, lorazepam, and placebo: A double-blind, randomized study in acutely agitated patients with dementia [J].
Meehan, KM ;
Wang, HE ;
David, SR ;
Nisivoccia, JR ;
Jones, B ;
Beasley, CM ;
Feldman, PD ;
Mintzer, JE ;
Beckett, LM ;
Breier, A .
NEUROPSYCHOPHARMACOLOGY, 2002, 26 (04) :494-504
[36]   Repetitively violent patients in psychiatric units [J].
Owen, C ;
Tarantello, C ;
Jones, M .
PSYCHIATRIC SERVICES, 1998, 49 (11) :1458-1461
[37]  
*PFIZ INC, 2001, BRIEF DOC ZIPR MES I
[38]  
REGIER DA, 1990, JAMA-J AM MED ASSOC, V264, P2511
[39]  
SALZMAN C, 1988, J CLIN PSYCHIAT, V49, P13
[40]   A review of the safety and efficacy of droperidol for the rapid sedation of severely agitated and violent patients [J].
Shale, JH ;
Shale, CM ;
Mastin, WD .
JOURNAL OF CLINICAL PSYCHIATRY, 2003, 64 (05) :500-505