Mohr Pavel, Pecenák Ján, Svestka Jaromír, Swingler Dave, Treuer Tamás
Prague Psychiatric Center, Czech Republic.
Neuro Endocrinol Lett. 2005 Aug;26(4):327-35.
Several psychotic disorders, including schizophrenia, may be associated with symptoms of acute agitation and aggression. While drug treatment of agitation is often essential, non-pharmacological interventions, both environmental and behavioral, also play important roles in the complex management of agitated patients. The most extensively used psychotropic drugs are parenteral formulas of conventional antipsychotics and benzodiazepines. Recently, injection forms of two second generation antipsychotics, olanzapine and ziprasidone, have become available. Both drugs have shown adequate efficacy and tolerability in several double-blind trials of intramuscular administration in acutely agitated psychotic patients. Compared to conventional medication, injection forms of the new antipsychotics may have a faster onset of action and more favorable profile of adverse events. Alternative approaches to injection administration include liquid drug formula, orally disintegrating tablets and wafers, treatment initiation with high doses, or rapid dose escalation. Evidence suggests that second-generation antipsychotics should be among the first-line choices in the treatment of agitation in acute psychosis.
包括精神分裂症在内的几种精神障碍可能与急性激越和攻击症状有关。虽然对激越进行药物治疗往往至关重要，但环境和行为方面的非药物干预在激越患者的综合管理中也发挥着重要作用。使用最广泛的精神药物是传统抗精神病药物和苯二氮䓬类药物的肠胃外剂型。最近，第二代抗精神病药物奥氮平和齐拉西酮的注射剂型已上市。在几项针对急性激越的精神病患者进行肌肉注射的双盲试验中，这两种药物均显示出足够的疗效和耐受性。与传统药物相比，新型抗精神病药物的注射剂型可能起效更快，不良事件的情况更有利。注射给药的替代方法包括液体制剂、口腔崩解片和薄片、高剂量起始治疗或快速剂量递增。有证据表明，第二代抗精神病药物应作为急性精神病激越治疗的一线选择之一。
