Psychiatry Division, Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa Pisa, Italy.
Front Psychiatry. 2013 May 7;4:26. doi: 10.3389/fpsyt.2013.00026. eCollection 2013.
Agitated behavior constitutes up to 10% of emergency psychiatric interventions. Pharmacological tranquilization is often used as a valid treatment for agitation but a strong evidence base does not underpin it. Available literature shows different recommendations, supported by research data, theoretical considerations, or clinical experience. Rapid tranquilization (RT) is mainly based on parenteral drug treatment and the few existing guidelines on this topic, when suggesting the use of first generation antipsychotics and benzodiazepines, include drugs with questionable tolerability profile such as chlorpromazine, haloperidol, midazolam, and lorazepam. In order to systematically evaluate safety concerns related to the adoption of such guidelines, we reviewed them independently from principal diagnosis while examining tolerability data for suggested treatments. There is a growing evidence about safety profile of second generation antipsychotics for RT but further controlled studies providing definitive data in this area are urgently needed.
激越行为占急诊精神科干预的 10%。药物镇静通常被用作激越的有效治疗方法，但缺乏强有力的证据支持。现有文献显示，不同的建议得到了研究数据、理论考虑或临床经验的支持。快速镇静（RT）主要基于药物的静脉治疗，关于这个主题的少数现有指南在建议使用第一代抗精神病药和苯二氮䓬类药物时，包括耐受性有问题的药物，如氯丙嗪、氟哌啶醇、咪达唑仑和劳拉西泮。为了系统地评估采用此类指南的安全问题，我们在检查建议治疗的耐受性数据的同时，根据主要诊断对其进行了独立审查。越来越多的证据表明第二代抗精神病药在 RT 中的安全性良好，但迫切需要提供该领域明确数据的进一步对照研究。
