Bosanac Peter, Hollander Yitzchak, Castle David
Director, Clinical Services, St Vincent's Mental Health Service, Melbourne, VIC, Australia.
Australas Psychiatry. 2013 Dec;21(6):554-62. doi: 10.1177/1039856213499620. Epub 2013 Aug 31.
To review the current role and comparative efficacy of short-acting intramuscular (IM) antipsychotics in the management of acute agitation, in current clinical practice.
The efficacy and tolerability of IM antipsychotics in the management of acute agitation in current clinical practice were reviewed in the Medline, PubMed, Cinahl Plus, Scopus-v.4 and PsycInfo databases.
The comparative efficacy of the rapidly-acting IM atypical antipsychotics (olanzapine, ziprasidone and aripiprazole) is similar to that of the typical antipsychotic, haloperidol. IM olanzapine and ziprasidone were associated with fewer extrapyramidal side-effects and had similar cardiac tolerability to IM haloperidol.
Further studies are required in the ongoing development of contemporary, evidence-based clinical guidelines in acute agitation, including head-to-head comparisons of currently utilized IM atypical antipsychotics, sequential treatment or combinations of medications.
回顾短效肌内注射抗精神病药物在当前临床实践中对急性激越的管理作用及比较疗效。
在Medline、PubMed、Cinahl Plus、Scopus-v.4和PsycInfo数据库中检索肌内注射抗精神病药物在当前临床实践中对急性激越的管理作用及比较疗效。
快速起效的肌内注射非典型抗精神病药物（奥氮平、齐拉西酮和阿立哌唑）的比较疗效与典型抗精神病药物氟哌啶醇相似。肌内注射奥氮平和齐拉西酮的锥体外系副作用较少，且心脏耐受性与肌内注射氟哌啶醇相似。
在急性激越的当代循证临床指南的持续制定过程中，需要进一步开展研究，包括对目前使用的肌内注射非典型抗精神病药物进行直接比较、序贯治疗或联合用药。
