Marder Stephen R
Department of Psychiatry, David Geffen School of Medicine at the University of California Los Angeles, VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, Calif, USA.
J Clin Psychiatry. 2006;67 Suppl 10:13-21.
Agitation is an important therapeutic target in the acute and/or emergent setting, as well as for longer-term care of patients with psychiatric illness.
Select reviews and guidelines published (from 2000 to 2006) on the treatment of agitation in various psychiatric disorders were evaluated.
After maximizing the safety of all individuals in the presence of an acutely agitated patient, initial therapy generally involves verbal deescalation. Pharmacologic management of acute agitation relies on typical antipsychotics, particularly haloperidol; benzodiazepines; and atypical antipsychotics. The selection of a specific agent (or combination of agents) should be guided by etiologic considerations, efficacy of the drug(s), side effects, potential drug interactions, and drug formulation. Seclusion or restraints are treatments of last resort due to safety issues.
Compared with conventional antipsychotics (e.g., haloperidol), preliminary evidence indicates that atypical antipsychotics effectively reduce agitation, are better tolerated, and have fewer side effects. After an acute episode, atypical agents also help ease the transition from intramuscular to oral medication to promote ongoing treatment.
激越在急性和/或紧急情况下是一个重要的治疗靶点，对于精神疾病患者的长期护理也是如此。
对2000年至2006年期间发表的关于各种精神障碍中激越治疗的综述和指南进行评估。
在急性激越患者面前确保所有人安全最大化后，初始治疗通常包括言语安抚。急性激越的药物治疗依赖于典型抗精神病药物，尤其是氟哌啶醇；苯二氮䓬类药物；以及非典型抗精神病药物。特定药物（或药物组合）的选择应依据病因、药物疗效、副作用、潜在药物相互作用和药物剂型来指导。由于安全问题，隔离或约束是最后的治疗手段。
与传统抗精神病药物（如氟哌啶醇）相比，初步证据表明非典型抗精神病药物能有效减轻激越，耐受性更好，副作用更少。急性发作后，非典型药物还有助于从肌肉注射过渡到口服药物，以促进持续治疗。
