UC San Diego Health System, Department of Emergency Medicine, San Diego, California.
West J Emerg Med. 2012 Feb;13(1):26-34. doi: 10.5811/westjem.2011.9.6866.
Agitation is common in the medical and psychiatric emergency department, and appropriate management of agitation is a core competency for emergency clinicians. In this article, the authors review the use of a variety of first-generation antipsychotic drugs, second-generation antipsychotic drugs, and benzodiazepines for treatment of acute agitation, and propose specific guidelines for treatment of agitation associated with a variety of conditions, including acute intoxication, psychiatric illness, delirium, and multiple or idiopathic causes. Pharmacologic treatment of agitation should be based on an assessment of the most likely cause of the agitation. If agitation results from a delirium or other medical condition, clinicians should first attempt to treat the underlying cause instead of simply medicating with antipsychotics or benzodiazepines.
在医疗和精神科急诊室中,激越很常见,因此对于急诊临床医生来说,恰当的激越管理是一项核心能力。在这篇文章中,作者回顾了使用各种第一代抗精神病药物、第二代抗精神病药物和苯二氮䓬类药物治疗急性激越的情况,并针对各种情况下的激越治疗提出了具体的指南,包括急性中毒、精神疾病、谵妄以及多种或特发性原因。激越的药物治疗应基于对激越最可能原因的评估。如果激越由谵妄或其他医学状况引起,临床医生应首先尝试治疗潜在病因,而不是仅仅使用抗精神病药或苯二氮䓬类药物进行治疗。