Objective: The authors evaluated the comparative efficacy and safety of intramuscular olanzapine, intramuscular haloperidol, and intramuscular placebo for the treatment of acute agitation in schizophrenia.
Method: Hospitalized patients with schizophrenia received one to three injections of intramuscular olanzapine, 10 mg, intramuscular haloperidol, 7.5 mg, or intramuscular placebo over a 24-hour period. Agitation was measured with the excited component of the Positive and Negative Syndrome Scale and two additional scales.
Results: According to scores on the excited component of the Positive and Negative Syndrome Scale, both intramuscular olanzapine and intramuscular haloperidol reduced agitation significantly more than intramuscular placebo 2 and 24 hours following the first injection. Intramuscular olanzapine reduced agitation significantly more than intramuscular haloperidol 15, 30, and 45 minutes following the first injection. No patients treated with intramuscular olanzapine experienced acute dystonia, compared with 7% of those who were treated with intramuscular haloperidol. No significant QT(c) interval changes were observed in any patients.
Conclusions: Intramuscular olanzapine represents a rapid, effective, and safe treatment for acute agitation in schizophrenia.
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http://dx.doi.org/10.1176/appi.ajp.158.7.1149 | DOI Listing |
Cureus
November 2024
Psychiatry, Mahatma Gandhi Memorial Medical College, Indore, IND.
Background The presence of psychiatric symptoms in pregnancy is a common occurrence that requires swift and effective management to avoid harm to self, caregivers, staff, and, above all, the reliant fetus. However, there is a dearth of knowledge, practical guidelines, and research in the context of managing agitated states of antenatal patients. To bridge this critical knowledge gap, this research endeavors to illuminate the practices surrounding the management of agitated pregnant women with respect to psychiatric emergencies in a tertiary care hospital.
View Article and Find Full Text PDFAm J Emerg Med
January 2025
Upstate University Hospital, Department of Pharmacy, 750 East Adams Street, Syracuse, NY, USA.
Introduction: This study sought to assess the cardiorespiratory safety of parenteral olanzapine and benzodiazepine combination treatment compared to parenteral droperidol or haloperidol and benzodiazepine combination treatment.
Materials And Methods: This was a retrospective chart review conducted in adult emergency department patients who received intramuscular (IM) or intravenous (IV) droperidol, haloperidol, or olanzapine within one hour of IM or IV benzodiazepine. Patients were stratified into groups based on whether they received either olanzapine in combination with a benzodiazepine (n = 48) or droperidol or haloperidol in combination with a benzodiazepine (n = 48).
Ned Tijdschr Geneeskd
October 2024
Pro Persona, ACT-VIP team, Nijmegen.
Ment Health Clin
October 2024
Vice Chief of Clinical Services, Department of Emergency Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York.
Introduction: Acute agitation is a common presenting symptom in medical and mental health emergencies that may require pharmacologic intervention. There is a manufacturer recommendation against intramuscular coadministration of olanzapine with parenteral (intramuscular or intravenous) benzodiazepines despite a deficiency of high-quality evidence. The purpose of this study was to contribute to available literature regarding intramuscular olanzapine and parenteral benzodiazepine use in acutely agitated patients in the emergency department (ED).
View Article and Find Full Text PDFMent Health Clin
August 2024
Clinical Pharmacy Specialist, Psychiatry, Virginia Commonwealth University Health Department of Pharmacy Services, Richmond, Virginia.
Introduction: There is no consensus on the optimal antipsychotic for acute agitation. Whereas haloperidol is frequently used and has proven efficacy, second generation antipsychotics show similar efficacy and improved safety and tolerability. This study aimed to determine the effectiveness of short-acting intramuscular (IM) haloperidol versus other IM antipsychotics for acute agitation in adults admitted to an inpatient psychiatry unit.
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