Siwek Marcin
Psychiatr Pol. 2014 Sep-Oct;48(5):917-30. doi: 10.12740/pp/30255.
Psychomotor agitation is a widespread clinical problem both in patients with schizophrenia and BD. It is a highly hazardous condition, imposing significant risks in psychiatric emergency, as expressedby elevated ratios of adverse events and traumatic experiences (both for patients and medical staff). The available anti-agitation drugs have numerous disadvantages. The orally administered medications (even though preferable to:patients) take hours or even-days for the therapeutic effect to emerge .(and also there is a risk of exacerbating agitation in between). Although rapid onset of action (15-45 minutes) is a noteworthy merit of intramuscular drugs, such an invasive strategy is far too often bound to patients' anxiety, resistance, and traumatic experiences. The need for novel drug formulations (ideally, both integrating the benefits of injectable and orally administered tranquillizing medications, 'and free from their disadvantages) can be, therefore, clearly grasped. Development of.inhaled loxapine exemplifies the attempts to overcome the above-delineated obstacles. As suggested by the available research base, inhaled loxapine seems to be an effective anti-agitation drug in treatment of patients with schizoplhenia and BD (with the onset of action similar to the one observed in intramuscular antipsychotics). However, this formulation of loxapine is distinguished by its non-invasive route of administration, as accompanied by markedly, low risk of side effects or adverse events.
精神运动性激越在精神分裂症和双相情感障碍患者中都是一个普遍存在的临床问题。它是一种高度危险的状况,在精神科急诊中带来重大风险,如不良事件和创伤经历的发生率升高所表明的那样(对患者和医护人员都是如此)。现有的抗激越药物有许多缺点。口服药物(尽管对患者来说更可取)需要数小时甚至数天才能产生治疗效果(而且在此期间还有加剧激越的风险)。虽然肌肉注射药物起效迅速(15 - 45分钟)是一个值得注意的优点,但这种侵入性策略常常会引发患者的焦虑、抵触以及创伤经历。因此,对新型药物制剂的需求(理想情况下,既能整合注射用和口服镇静药物的优点,又没有它们的缺点)是显而易见的。吸入用洛沙平的研发就是克服上述障碍的尝试之一。现有研究表明,吸入用洛沙平似乎是治疗精神分裂症和双相情感障碍患者的一种有效的抗激越药物(起效时间与肌肉注射抗精神病药物相似)。然而,这种洛沙平制剂的特点是给药途径非侵入性,同时副作用或不良事件的风险明显较低。